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Sleep apnea

[Name of the Writer]

[Name of the Institution]

Sleep apnea

A nurse plays a vital role in the recovery process of any patient. Their performance matters a lot when a patient is in a critical situation and needs support and help. There are many patients in the hospital that encounters sleep disorders of various kinds. If the nurses know about the sleep disorders types and symptoms they can identify them and help the patients so that they can be treated. Nurses are often the first ones to know the sleep disorder of a patient in the hospital as they are taking care of the patient. Due to this, I have selected an article on sleep apnea.

Sleep apnea is a type of disorder in which breathing potentially stops and start repeatedly while a person is asleep. It is caused by caused when the throat muscle relaxes. It has three types. The first one and the most common type is obstructive sleep apnea (OSA) in which the throat muscle relaxes causing complete or partial obstruction of the airway (LYLE D VICTOR, 1999). The second is central sleep apnea which is caused when the muscles responsible for controlling the breathing process are not getting proper signals from the brain. The third one known as complex sleep apnea is basically the combination of the above-mentioned types. In this article, the basic focus will be on obstructive sleep apnea.

According to studies, 1 out of every 5 adults have OSA and almost 18 million people in the US have this condition. Although more than 20% have been diagnosed with sleep apnea and got treated (Davis, 2018).

Being a nurse it is important to know this common type os sleep apnea as most of the patients experience this without even knowing that they have a sleep disorder. When a person is suffering from obstructive sleep apnea the symptoms they experience are snoring, dry mouth, headaches, and, sleep deprivation. There are certain risk factors that increase the chances of a person having OSA. Some of them are obesity, genetics, narrowed airway, nasal congestion, and, etc. Sleep apnea of any type can be cured (Quan & Kapur 2019). The treatment includes surgery in which the surgeon widens the airway and continuous airway pressure therapy. However, it is important to do major lifestyle changes as well as to cure and prevent sleep apnea.


BIBLIOGRAPHY Beauchamp, G. (2008). The Benefits of Business Analysis. Retrieved from Modern analyst.com: https://www.modernanalyst.com/Resources/Articles/tabid/115/articleType/ArticleView/articleId/602/What-are-the-Benefits-of-Business-Analysis.aspx

Davis, K. (2018, 01 18). What you need to know about sleep apnea. Retrieved 2019, from Medical News Today: https://www.medicalnewstoday.com/articles/178633.php

LYLE D VICTOR, M. (1999). Obstructine sleep apnea. American family physicians, 2279-2286.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Article Critique Worksheet

Article Critique Worksheet

Provide the full reference for the article using APA format. In addition to the reference note, please provide the link to the article in the GCU library.

Solbrig, L., Jones, R., Kavanagh, D., May, J., Parkin, T., & Andrade, J. (2017). People are trying to lose weight dislike calorie counting apps and want motivational support to help them achieve their goals. Internet interventions, 7, 23-31.

Describe the health issue that is the focus of the article. Summarize the intervention used as a health promotion or health behavior change intervention.

The obesity epidemic is growing steadily across the world, and currently, not a single country can reverse it. So the health issue that is addressed in this article is obesity. According to WHO obesity is the energy imbalance between calorie expanded and calorie consumed. So this article explores the epidemic of obesity by using a mobile app that helped them to monitor their calorie intake, weight loss and maintain weight loss.

Identify the methodology used in this study.

In this article six focus groups were selected from the public pool of people who were interested in participating in the study. The participants were given mobile phones with the weight loss app. The participants were motivated by giving incentives, and also they communicated with each other through the app to motivate each other.

Assess the organization and focus of the study materials.

The focus of the study material is the obese patients of United Kingdom and also the school going children due to their lifestyle, eating habits and use of mobile phones.

Evaluate whether the argument presented in the study is understandable and justify your point of view with supporting evidence. Is the argument or presentation understandable?

The argument that is presented in this study is that mobile phones are easily accessible; therefore the healthcare policymakers are now installing apps on interested people mobile phones. It is argued that most people spend their time on mobile phones, so it is easy to motivate them by introducing weight loss apps on their phones. Although it's interesting, I think that without the intervention of nurses or healthcare individuals it is not easy to keep the patients motivated. So the drawbacks are quite prominent in this article.

Identify the audience for the article and discuss whether the author included appropriate information and language for that audience.

The audience of the article is policymakers and obese patients worldwide because he used easy and understandable language and the tool that he used is also cost-effective and easily accessible. The information is not enough in this article like what were the causes of obesity in the selected population, their calorie intake and before and after results.

Describe the study results and discuss whether the intervention was successful in promoting behavior change among the individuals of that population.

As in this study, the experimental groups were provided with mobile apps to keep them motivated for weight gain control. They were kept motivated without the help of public health individuals. The mobile apps were used to control their calorie intake and to keep them motivated but it was noted that self-monitoring became boring in some of the participants and the public health workers had to intervene in such situation. It was also noted that when the participants communicated and shared their weight loss achievement with other app users, then they got motivated too but for a short period.

Discuss the applications, recommendations, or implications the author offers based upon the study results.

The author wants to make a point by saying that weight loss is not attainable without the intervention of public health strategists. To motivate obese people, the policymakers should design some apps in mobile phones because everyone has a personal phone and with the help of the apps, the users can monitor themselves, their calorie intake and physical activity. Although the approach becomes boring with time, the apps should be user-friendly and fun to motivate the users. But his point is that such even introducing apps nurses should also play their role by encouraging obese people to exercise.

Discuss whether you believe the article is relevant and useful to public health. Justify your ideas with supporting evidence.

This article is relevant to public health because obesity is becoming endemic with no proper treatment. Therefore, there should be a proper way to solve this problem. The approach that is used in this article is very effective because we all own cell phones and if we have the tool to weight loss or control in our pockets then it can be of great help to obese people.

Discuss whether there was information missing from the study if shortcomings are identified, including discussion of information that should have been included. Justify your ideas with supporting evidence.

The study is not comprehensive. For example, it is stated in the study that by sharing weight loss stories on the app some of the participants gave motivation to other users but it isn't stated anywhere in the study that how many participants lost motivations while using the app. What were the before and after results of the study? And what parameters were taken for the patients who later stop using the app? Also, the study is failed to identify the target groups, the complete information about gender and age of the participants is not given.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Article Reflection

Article Reflection

[Name of the Writer]

[Name of the Institution]

Article Reflection

The article by Julie Leask and her peers focus on the exploration of the ways journalists select and form the news related to the healthcare problems in Australia. As it is well known that the media has this enormously influential role with the response of the public about healthcare, it is essential for the awareness of healthcare issues. Many researchers have centered their attention on the media role in the creation of health understanding and mindfulness. This article includes a study in which sixteen journalists were interviewed on semi-structured style between October and August of 2006-2007 (Leask, Hooker & King, 2010). These journalists were from many types of media centers and ranks.

The outcomes of the interview gave significant concerns and issues related to healthcare reporting for the journalists and also the interests of healthcare professionals. The primary findings of this article were that journalists endeavored on routinely bases to adjust unique and contending points while conducting the quality news reporting and functional limitations (Leask, Hooker & King, 2010). The authors distinguished among these limitations through an inspection of routinely newsgathering schedules of the journalists, including time, limits, opportunities, and due dates. Further constraints included the selection of the news and framing the edge, exploring and citing sources, and the ethical considerations of reporting.

This examination meant to distinguish the ways journalists of every segment of the print media industry do jobs inside their associations to choose, form and convey the reports related to healthcare. The examination offers proposals for general wellbeing experts in accomplishing all the more successfully with the media. This investigation featured that time limitations and access to stories of healthcare sector (Leask, Hooker & King, 2010). They additionally discovered that the subsidiary idea most of all stories cultivate the similar pattern in the story, also keep the level as of basic reporting. Journalists had the same uncertainties from the healthcare experts related to the understanding, precision and societal effect of the coverage (Leask, Hooker & King, 2010). The authors also depicted the significance of the excellence of wellbeing and medicinal journalists: having standard dimensions of specialized information to enable them to amplify dedicated precision; consult to the producers and editors for the determination, as well as the point of therapeutic stories, by assembling and continuing the systematic of resources.

There are certain limitations in the study, as it is restricted due to a moderately lower rate of media experts and not gave the full investigation about the way a specific job impacted the creation of stories or news. Moreover, center point of this study was to comprehend the reporting of avian flu, which also limits its practicality over other issues. However, critically this study proposes that improved advocacy of general wellbeing resulted the suggestions the wellbeing experts, and also the journalists, i.e., timing, accessibility, availability of resources, individual communications, organized way of handling and considering moral qualities.

Despite the future media scene, the authors contended that communicators of general health should be tactical in the way of working with the journalists; all the guidelines related to the communication with the media channels must be kept in mind. Thus, they can lower the burden by making higher advantages of modern media settings. However, I have experienced the use of media in healthcare while conducting a campaign about breast cancer in an eastern country.


Leask, J., Hooker, C., & King, C. (2010). Media coverage of health issues and how to work more effectively with journalists: a qualitative study. BMC public health, 10(1), 535.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Assessment 1

Critical Analysis of a case study of Mr. Bright


[Name of the institute]


[Tutor name]

Words count = 1143

Critical Analysis of a case study of Mr. Bright

Coronary angioplasty is a procedure to open the heart’s blocked arteries. It consists of a putting a balloon temporarily in the arteries to widen them. Sometimes a wide wire is put in arteries called stent to prevent them from narrowing again. Some stents are medicated to keep the arteries open while others are just bare metal stents. Angioplasty can improve chest pain and short breathing problem. It will prevent your heart from getting damaged (Coronary angioplasty and stents - Mayo Clinic., 2019).

In the case study, Mr. Bright was having a heavy pain on the left side of his chest and the pain used to go up to his jaw and down to left arm. He visited a doctor who examined him and he was assisted by a nurse. He was asked about the pain history and his health condition as well. He said that he smokes 20 cigarettes day plus he has blood pressure problem and sugar problem as well. He was also having minor myocardial pain. He was asked to come the next day for further procedures. The next day he got angioplasty and the nurse checked his vital signs. She did the assessment through vital sign monitory. She checked her blood pressure and did his ECG which showed that he has 10 percent blockage in his artery. After having done the angioplasty the assessment of his glucose level was done by BGL monitoring, which showed his Diabetes as 10.0. BGL monitoring is a procedure for identifying the body glucose level. It helps to identify the level of insulin in the body and then it helps the doctor to recommend exercise and specific food for the patient. (Money, Caldwell, & Sciarra, 1999).

The nurse and doctors examined Mr. Bright with an ISBAR framework. ISPR is Introduction, Situation, Background, Assessment, and Recommendation and it is helpful in getting patient history with full information and important details. It is a very easy way of investigation about the health of a patient before he/she is hospitalized. The elements of ISPR that were used in MR. The bright case was his introduction, he was asked to give details about himself. Secondly, he was asked to highlight the background of this problem, like how it happened and when it happened for the first time? Then the doctor did an assessment by saying what do you think what it could be (O’Rourke, 2007)

The nursing care procedure that was lacking in the case of Mr. Bright was, firstly he was not informed by the doctor about his angioplasty so the recommendation part was missing from the procedure. He was been given sublingual GTN for the relief of the pain. But he was not been given any optimal care as the chest pain needs very optimal sort of care. Such patients need additional interventions. As the National Heart, Lung and Blood Institute PTCA says that 4.6% of the angioplasty patients suffer from coronary occlusions, and 4.8% have a myocardial infarction. So the majority of the patient have pain may be due to stretching of veins. So it should be kept in mind that other sorts of chest pay will occur after angioplasty (Ronnevig, Bjorsvik, Gullestad, & Forfang, 2003). But in the case of Mr. Bright his chest pain after angioplasty was not given that attention.

He was not given any guideline to follow after his angioplasty. That the insertion area needs to be cleaned twice a day. The area needs to be kept clean and dry, cream and lotions should not be used in that area. Lose clothes should be worn by the patient (Fischman et al., 1994).

The patient should not participate in any energetic activity for 5 days and heavy lifts to be avoided and the patient should not be straining during bowel movement. The patient needs to avoid stairs and the left arm is not frequently used till recovery (Anand, et.al, 2005).

Mr. Bright was not given a fluid guideline and follow up meetings were not arranged. He was not given the guidelines on what to eat and what not to eat. Although his the checked his diabetes but did not show any concern regarding the medication that might affect his sugar level. He was not given any health care tips for the future. He was not enrolled in the outpatient cardiac rehabilitation program, which suggests diet good for a healthy heart and also helps to quit smoking. Mr. Bright was a smoker but after his treatment, he was not encouraged to quit smoking.

Chest pain is an emergency situation and timely assessments need to be done. It requires highly skilled nurses for performing timely and accurate assessments. When a patient comes in the emergency department then the nurse performs a brief assessment and based on that assessment the level of urgency is indicated. After this further comprehensive assessment is done. The nurse should be using various techniques for this assessment and this might be chaotic to have a face to face communication with the patient (Munroe, Curtis, Murphy, Strachan, & Buckley, 2015).

Well, the doctor used simulation when Mr. Bright came to visit her and she advised the patient regarding his chest pain. The simulation can be accessed by ISBAR format as:

The ISBAR Format focuses on relevant details. It helps to focus on the most related information and avoid unnecessary information. The elements are;

• Introduction:

Mr. Bright introduced himself in front of the doctor and gave his date of birth which is 25th May 1950. He also let the doctor know that he is there due to a chest pain which he is having frequently.

• Situation

In the situation, the current happenings are discussed. Mr. Bright let the doctor know that he is having a pain in his chest, which goes up to his lower jaw and down to his left arm.

• Background

In the background, the issues that lead to pain are discussed. The doctor asked about his previous health problems and Mr. Bright said that he is a diabetes patient and he is taking medicine for it. He also let the doctor know that he has a blood pressure problem. He is a smoker as well as he drinks a lot. He also let the doctor know about the medicines he was using before.

• Assessments

Assessment is about the patient understanding of what his pain is all about. Well, Mr. Bright was not asked what this chest pain could be but he knew that he has a heart problem as the symptoms were clear.

• Recommendation

Recommendation deals with the idea that what could be done in such circumstances and Mrs. Bright was informed that his husband is going to have angioplasty and he will get rid of the pain (O’Rourke, 2007).

So the doctor and nurses followed ISBAR factors to do Mr. Bright’s assessment and he got relief from his pain


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Coronary angioplasty and stents - Mayo Clinic. (2019).

Fischman, D. L., Leon, M. B., Baim, D. S., Schatz, R. A., Savage, M. P., Penn, I., … Nobuyoshi, M. (1994). A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. New England Journal of Medicine, 331(8), 496–501.

Money, E. W., Caldwell, R., & Sciarra, M. (1999). Vital sign remote monitoring device. Google Patents.

Munroe, B., Curtis, K., Murphy, M., Strachan, L., & Buckley, T. (2015). HIRAID: An evidence-informed emergency nursing assessment framework. Australasian Emergency Nursing Journal, 18(2), 83–97.

O’Rourke, M. (2007). The Australian Commission on Safety and Quality in Health Care agenda for improvement and implementation. Asia Pacific Journal of Health Management, 2(2), 21.

Ronnevig, M., Bjorsvik, E., Gullestad, L., & Forfang, K. (2003). A descriptive study of early nonspecific chest pain after PTCA: important area for the acute health care personnel. Heart & Lung, 32(4), 241–249.

Anand, S. S., Xie, C. C., Mehta, S., Franzosi, M. G., Joyner, C., Chrolavicius, S., ... & CURE investigators. (2005). Differences in the management and prognosis of women and men who suffer from acute coronary syndromes. Journal of the American College of Cardiology, 46(10), 1845-1851.

Subject: Healthcare and Nursing

Pages: 3 Words: 900

Assessment 1 - Person Centred Care


Author’s name

Class name


School name

City and state



This assignment is intended at elaborating the meaning of person centered assessment and how it is estimating its significance with respect to the aged care. Moreover, based on the conversation with an elderly, it will be explained how person centered planning works and what is their potential perspective on this type of assessment. In the next section, arguments will be developed in relation to the favorableness and inappropriateness of person centered assessment and settled on the logical grounds of preexisting literature. The discussion section will analyze whole textual activity. It will be reflected how this plan could be used for the elderly to have successful ageing. Conclusion section, in the end, will wrap the text into a single paragraph deducing meaningful inferences from it.


The person that I talked to was 75 years old Roberts living in residential care home; far from his family and loved ones. He was suffering from common ageing condition known as dementia. He found it hard to remember his children, siblings, significant others, familiar places and pleasant experiences. We first had a general discussion but he was too reluctant to be open and talk, it took me 2 meetings to develop rapport with him and reach at the problem issue. Cutting long into short, he had favorable views about person centered assessment plan because it was focused more on what he thinks, feels, desires and says. Rest of the approaches does not consider client’s uniqueness rather he is subjected to universal intervention strategies discounting his agreeableness and willingness to comply with them. Moreover, he was contented with the care provider’s positive, optimistic and altruistic attitude because dementia snatched his sense of self and past life experiences partially and it was quite devastating for him. Hence healthcare providers’ attitude was the only reason for him to be contented and feeling valued. He also demonstrated a strong desire to be at home because it gives him sense of accomplishment when he watches his grand children playing and accomplishing their academic objectives. His home was the source of nourishment for him as all the possessions enable him to feel how productive he remained during his life.


The concept of person centered care acquired wide acceptance and acknowledgement in nursing particularly with the ground breaking philosophies of Kitwood (1997). According to him, core elements in the personhood encompass uniqueness, embodiment and relationship. He suggested that recognition, respect, trust and nature of certain experiences that the individual attains from his relationships are highly influential for his ego development.

Based on the Darwin’s theory of individual differences, he propounded the most significant and intriguing notion that we must avoid generalizing concepts to the human diversity because each human being is unique not only physically but his cognitive patterns, thinking, feeling, perception, outlook, orientation preference, attitude, resiliency, coping, problem solving, decision-making, behavior and personality follow unique and holistically unparallel patterns (Brooker, 2005). Embodiment is referred to as the nature of experiences that he acquires while interacting his environment and other individuals. His experiences may have huge variations in terms of constructive and destructive ramifications (Brooker, 2008).

Person centered plan is aimed at enhancing the quality of life for people suffering from physical and cognitive impairments. The key components in the care planning of individuals with dementia include personhood and care based on relationships, meaningful engagement and individualized care, and positive social environments (Fazio et. al., 2018; Ali et. al., 2016). Personhood and relationship-based-care are aimed at respecting and seeking to comprehend the behaviors and subjective experiences of elderly individuals living with dementia. Individualized care and meaningful engagement is specifically demonstrated and practiced during sessions with the client aimed at prioritizing information about individual’s self concept, ego identity, needs, wishes, desires, values, preferences, perceptions, attitudes, routines and sources of pleasure. The third component, relationship-based care and positive social environments, is intended at identifying the client’s needs of love, belongingness, support and affiliation with the care partners.

Another person centered approach to dementia assessment conjoins two perspectives; idiographic and nomothetic approaches. Nomothetic approach consults bulk of preexisting literature addressing the issues of patients with dementia, their distressing behavioral ramifications, general principles and evidence-based treatment interventions from same problem group. Idiographic approach is largely reliant upon the profound data obtained from the individual in terms of his thoughts, feelings, life history, ways of dealing with previously encountered problems, attitudes for embracing stressful situations, preferences, dreams, hopes, aspirations, accomplishments, failures, significant identity roles, experiences and all the information about his social and autobiographical world (Mast, 2011).

Moreover, all the information regarding patient’s primary care providers, significant others, his past and current relationship with them and associated satisfaction are undertaken thorough contemplation. As this information cannot be obtained using single meeting session, multiple sessions are required to gather complete information with regular or intermittent intervals (Beck et. al., 1996; Barbe et. al., 2016). This information is not only helpful for dementia care planning but for other problems as well hence, it must be revisited and updated periodically and must be shared with other care providers for achieving holistic healthcare goals.

A bulk of literature provided significant consideration to the meaning of home—a primordial component in dementia care planning. Although the meaning of “home” encapsulates greater variations yet meta-synthesis conducted by Malony (2010) gathers the home ideas under one umbrella. He explained home as a pragmatic place of endorsement, refuge, ontological safety, warmth, comfort, significant relationships with other individuals, places, animals, ideas, times, deliberately cultivated possessions, self rapprochement and maintaining self-concept when subjected to loss of transitions. It is important to assess and comprehend the personalized perception of patients about home and their experiences associated with it regarding its building, sharing, sustenance and loss (Beer et. al., 2010). This assessment provides broader term to the social, emotional, psychological and physical domains of client’s life.

The above mentioned elaboration reflects the concept of person centeredness informed by Brooker, Kitwood, Mast, Malony and Fazio and his colleagues. Based on the concepts, three reflective questions many help the assessor to enter client’s world. 1) What could be the best possible way to manifest empathy, congruence and unconditional positive regard in relation to the client’s wholeness and uniqueness particularly when his weaknesses/ problems are being discussed (e.g., dementia and its associated maladjusted behaviors)? 2) What could be the best possible way to demonstrate feelings regarding therapeutic partnership and alliance with the client and other care partners? 3) What could be the best possible way to demonstrate optimism for enhancing individual’s quality of life and fostering hope?

Numerous qualitative studies (observation, interviews) conducted to examine the experiences of elderly living with dementia suggest that the role of care provider is irrefutable in enhancing their quality of life and developing optimism (Frank & Forbes, 2017). Care providers’ attitudes greatly influence the outlooks and perceptions of elderly about dementia. Simple verbal and gestural communication strategies must be given serious consideration because care providers’ pessimism has the potential to threaten the healthcare outcomes of elderly with dementia (Wolverson, Clarke, & Moniz, 2016).


Person centered planning is referred to as the clinical process aimed at identifying the needs, desires, strengths, capacities and desired healthcare outcomes of the person, typically directed by individual’s family or himself (Bryden, 2016). In order to elicit information about all the above mentioned aspects, person centered assessment tool is used so that it could be utilized while developing and implementing a favorable individual service plan ensuring his paced recovery in physical, mental, emotional and social terms (Kim & Park, 2017).

The concept of person centeredness was first introduced by Humanistic psychologists; Abraham Maslow and Carl Rogers. They suggested that psychological assessment and treatment must be centered on the client’s desires and self- determination because it is only the individual who knows about his strengths, weaknesses, problems and future aspirations better than anyone else (Crandall et. al., 2007). Psychologists are not the ones to decide or direct their treatment path rather their duty is limited at enabling the client to retrospect and identify the nature of his personal attributes (Wood et. al., 2015).

The presented literature explained the meaning of person centered approach regarding dementia. The common theme followed by all of these figures was “connectedness”, connectedness and sense of belonging with other individuals, places (home) or animals that remind them of their past life, nurture their current sense of self and strengthen their optimism for future life. Same thoughts were communicated by the patient I interviewed. This sense of self can be improvised with the positive and optimistic attitude of caregiver, also communicated by the Roberts. Hence, being healthcare provider in aged care community, I would develop optimism and favorable communication skills so that clients’ perception could be altered about his illness and they could feel better with the full fledge focus over their future treatment outcomes.


In this paper it was demonstrated that person centered assessment planning was a psychological idea and gained wide acceptance in nursing as well. To gain a profound understanding about living experiences and perspectives of patients living with dementia, Roberts was undertaken unstructured interview. He demonstrated contentment about person centered care due to two main reasons 1) positive and optimistic attitude of care providers 2) maintenance of dignity and worth of his self determination, strengths and desires by care providers. Next, it was explained how current literature addresses this plan including the philosophical and research based ideas of Brooker, Kitwood, Mast, Malony Fazio and so on. On the whole, this activity enabled me to develop an in-depth insight about the significance of communication skills and patient’s self determination.


Falvey, M, Forest, M, Pearpoint, J, Rosenberg, R, 1997. All My Life's a Circle: Using the Tools--Circles, MAPS and PATH. New Expanded Edition. Available at https://eric.ed.gov/?id=ED528076

O'Brien, J, Jack, P, & Lynda K, 2010. The PATH & MAPS handbook ; Person-centered ways to build community. Available at http://www.inclusion.com/books/pathmapshandbook.pdf

Fazio, S, Pace, D, Flinner, J, Kallmyer, B. 2018. The fundamentals of person-centered care for individuals with dementia. The Gerontologist, 58(1): pp.S10–S19. doi:10.1093/geront/gnx122.

Frank, C, & Forbes, R. F, 2017. A patient’s experience in dementia care: Using the “lived experience” to improve care. Canadian Family Physician Medecin De Famille Canadien, 63: pp.22–26. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5257215/

Brooker, D, 2008. What makes life worth living?Aging & Mental Health , 12: pp.525–527. doi:10.1080/13607860802357886

Kitwood, T, 1997. Dementia reconsidered: The person comes first. Buckingham: Open University Press.

Kim, S. K, & Park, M, 2017. Effectiveness of person-centered care on people with dementia: A systematic review and meta-analysis. Clinical Interventions in Aging, 12: pp.381–397. doi:10.2147/CIA.S117637

Wood, A. M, Hilda, O. H, Christopher, J, Boyce, & Graham, D, 2015. An Existential-Humanistic View of Personality Change: Co-Occurring Changes with Psychological Well-Being in a 10 Year Cohort Study. Soc Indic Res., 121(2): pp.455–470. doi: 10.1007/s11205-014-0648-0

Ali, N, Luther, S. L, Volicer, L, Algase, D, Beattie, E, Brown, L. M, Joseph, I. 2016. Risk assessment of wandering behavior in mild dementia. International Journal of Geriatric Psychiatry , 31: 367–374. doi:10.1002/gps.4336

Beck, C., Algase, D. L., Kolanowski, A., Whall, A., Berent, S., Richards, K., & Beattie, E. 1996). Need-driven dementia-compromised behavior: An alternative view of disruptive behavior. American Journal of Alzheimer’s Disease and Other Dementias , 11, 10–19. doi:10.1177/153331759601100603

Barbe, C, Morrone, I, Wolak-Thierry, A, Dramé, M, Jolly, D, Novella, J, & Mahmoudi, R, 2017. Impact of functional alterations on quality of life in patients with Alzheimer’s disease. Aging and Mental Health , 21: pp.571–576. doi:10.1080/13607863.2015.1132674

Beer, C, Horner, L, Bretland, B, et. al. 2010. Factors associated with self and informant ratings of the quality of life of people with dementia living in care facilities: A cross sectional study. PloS One, 5: pp.e15621. doi:10.1371/journal.pone.0015621

Brooker, D. 2005. Dementia care mapping: A review of the research literature. The Gerontologist , 45(1): pp.11–18.

Bryden, C. 2016. Nothing about us, without us! 20 years of dementia advocacy. London: Jessica Kingsley Publishers.

Crandall, L. G, White, D. L, Schuldheis, S, & Talerico, K. A, 2007. Initiating person-centered care practices in long-term care facilities. Journal of Gerontological Nursing, 33: pp.47–56.

Wolverson, E, L,Clarke, C, & Moniz, E. D, 2016. Living positively with dementia: A systematic review and synthesis of the qualitative literature. Aging & Mental Health , 20: pp.676–699. doi:10.1080/13607863.2015.1052777

Subject: Healthcare and Nursing

Pages: 5 Words: 1500

Assessment 2

Title page


Description/ focus

The prevalence of HIV is significantly high among the immigrant community in Australia. New South Whales contains a larger population of the indigenous population who are the risk of developing HIV due to poverty. They are unable to adopt precautionary measures that could minimize the risks of this deadly disease. The facts depict that non-indigenous population is more likely to develop HIV compared to non-indigenous. Total cases of HIV reported in 2017 weer 417 that included 107 overseas. The evidence also reflects that the highest rate of 37% is of the immigrant population that suffers from HIV in NSW. This indicates that one-third of the immigrant population is a victim of HIV. The central reasons include lack of awareness regarding the cause and prevention of HIV. Inadequate access to healthcare also undermines their ability to fight against the disease.

Community assessment

Assessment 1: Patient is Torre Islander living in New South Whales. He was diagnosed with HIV at the age of 32. The patient with HIV revealed low cell count and increased viral load. CD4+ cells are deficiently estimated as less than 200 cells. The patient complained about other infections like pneumocystis and tuberculosis.

Quality of life diminished due to AIDS. The patient encounters mental social and physical issues. Reports difficulty in exercising or activities that demand physical input. Mental health is affected as the patient feels frustrated due to the disease. Reported difficulty in sleeping. The patient face difficulty to take part in social activities. He prefers to stay alone and experience discomfort in crowds.

Assessment 2: Patient is 37 years old Sub-Saharan African living in NSW. CD4+ cells count is less than 200. The patient developed other infectious diseases like pneumonia and extensive oral candidiasis. Low quality of life is recorded due to poor mental, social and physical health. The patient faces the fear of death and complains about pain. Mental issues include stress, sleeplessness and self-worthlessness CITATION Kat132 \l 1033 (Kirby, 2018). The social issues encountered by the patient include isolation, difficulty in interacting with others, aggression and impatience. The patient gets tired after performing a simple activity like walking. Cannot take part in activities that demand more physical input like running, lifting objects or jogging.

Summary of assessment

Both assessments indicate that the indigenous population in NSW, Australia experience mental, social and physical issues resulting from HIV. Fear of death cause unnecessary delays in screening and treatments.

Frequency and causes of HIV

During the past decade, the existence of HIV has increased significantly among indigenous people in New South Whales. Evidence suggests that “in 2017 the largest number of notifications was in the age group 30–39 years (312), followed by those aged 20–29 years (256) and those aged over 50 years” CITATION Kat132 \l 1033 (Kirby, 2018). Compared to non-indigenous, immigrants are facing high risks. The central causes of HIV include sexual contact, blood transfusion, through contaminated needles and breastfeeding. Another concern of HIV is that during pregnancy the disease is transferred to the baby. It is determined that HIV is high among overseas who belong to low-income groups. Poverty increases their chances of developing the disease because women are unable to take precautionary measures. “In 2017, HIV notification rates were highest among women aged 30–39 years (2.4 per 100 000), followed by those aged 20–29 years (1.5 per 100 000). Rates have declined by almost half among women aged 20–29 years since 2008 when the rate was 2.5 per 100 000” CITATION Kat132 \l 1033 (Kirby, 2018). Socio-economic factors have a strong correlation with the occurrence of disease because poor black women don't undergo a regular screening that could help in the timely diagnosis of HIV. Homelessness and poverty are also seen as individual risk factors. Elevation of HIV is also linked to the sexual mixing among low and high-risk groups of indigenous people. Living in poverty and sex ratio imbalance are also dominant factors that promote HIV CITATION Wad14 \l 1033 (Ivy, Miles, Le, & Paz-Bailey, 2014).

Initiatives for addressing the problem of HIV

Developing and adopting strategies that address the socio-economic factors of the indigenous and immigrant population in New South Whales.

Providing awareness to the women about safe sex and causes of transmission of HIV CITATION Gra171 \l 1033 (Graham, 'Connor, Chamberlain, & Hocking, 2017).

Adoption of health communication strategies that target the indigenous communities in New York.

Cost-effective delivery methods such as campaigning and advertisement can be used as effective tools for spreading the message of HIV prevention.

Providing guidance on taking precautionary measures such as convincing sexual partners to use condoms.

Encouraging women to undergo screening and providing free screenings for covering the maximum indigenous population in the city.

Gaps in healthcare and treatment

Some of the serious gaps in healthcare and treatment include the absence of appropriate mechanisms for supporting adherence and retention in care. Gaps in services and lack of funds have also discouraged timely diagnosis. Healthcare organizations poorly integrate the sexual and reproductive healthcare services that minimize the scope of treatment. Gaps in monitoring outcomes and the causes of disease have also increased the prevalence. Most of the organizations are poorly supported due to inadequate financial support from the state and welfare agencies CITATION Wad14 \l 1033 (Ivy, Miles, Le, & Paz-Bailey, 2014). Lack of counselling and supporting programs has also made treatments least practical for the patients CITATION Kat132 \l 1033 (Kirby, 2018).

Evidence-based strategies

The evidence states that the most effective strategy for minimizing the risks of HIV include behaviour change. This suggests the adoption of behaviour prevention programs that means encouraging African-American women to adopt safety measures. This involves awareness about the causes and encouraging to convince partners on using condoms. Improving medication adherence through counselling is also an effective strategy for treating HIV. Extended vaccines are effective for controlling disease among the indigenous population. Adoption of public health policies also helped in minimizing the risks of disease. Clinical preventive services such as regular cost-free screenings for the poor also encourage the indigenous community to receive treatment. Provision of free condoms to the poor black community is also a practical method CITATION Kat132 \l 1033 (Kirby, 2018).

SDH cycle

Barriers to implementation of strategies

The adoption of strategies is dependent on the financial capacity of the healthcare organization. It is thus important for the firm to generate adequate funds that could support the programs of awareness and education. Similarly, provision of free screenings for timely diagnosis also demands to fund from the state and non-state agencies such as NGO's and private healthcare organizations. Disparate healthcare resources and gender barriers have undermined the process of targeting a larger population. Societal barriers such as lack of family support and limited power of black females have also adversely impacted the implementation of strategies CITATION Kat132 \l 1033 (Kirby, 2018).


Healthcare providers have a profound role in helping the indigenous population in Australia that is facing risks of developing HIV. Engaging in treatment and strategic plans and programs can be effective for assisting minority population in minimizing the risks of this deadly disease. Effective strategies include the provision of free of cost screenings and treatment plans. Awareness about the causes of HIV can also be practical methods of controlling the disease.


Graham, S., 'Connor, S., Chamberlain, S. M., & Hocking, J. (2017). Prevalence of HIV among Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis. Send to Sex Health, 14 (3), 201-207.

Ivy, W., Miles, I., Le, B., & Paz-Bailey, G. (2014). Correlates of HIV Infection Among African American Women from 20 Cities in the United States. AIDS Behav, 18 (3), 266–275.

Kirby. (2018). Annual surveillance short report 2018. Kirby Institute.

Subject: Healthcare and Nursing

Pages: 4 Words: 1200

Assessment 2: Clinical Mentoring Plan Report For Mental Health Nursingye

Assessment 2

[Name of the Writer]

[Name of the Institution]


TOC \o "1-3" \h \z \u Introduction PAGEREF _Toc9637865 \h 2

Literature Review PAGEREF _Toc9637866 \h 3

Overview of mentee PAGEREF _Toc9637867 \h 5

Overview of mentor and mentee baseline PAGEREF _Toc9637868 \h 5

Mentor goals PAGEREF _Toc9637869 \h 5

Anticipated Mentee Goals discussed PAGEREF _Toc9637870 \h 6

Assumed Mentee Knowledge describes PAGEREF _Toc9637871 \h 6

Contextual factors PAGEREF _Toc9637872 \h 6

Attention and focus PAGEREF _Toc9637873 \h 6

Regulations PAGEREF _Toc9637874 \h 7

Patients as a major priority PAGEREF _Toc9637875 \h 7

Immediate Consultation PAGEREF _Toc9637876 \h 7

Potential Difficulties PAGEREF _Toc9637877 \h 7

Lack of practical knowledge PAGEREF _Toc9637878 \h 7

Lack of opportunities to learn PAGEREF _Toc9637879 \h 7

Issues of time management PAGEREF _Toc9637880 \h 7

Resources PAGEREF _Toc9637881 \h 8

Outline of objectives PAGEREF _Toc9637882 \h 8

Issues and Challenges PAGEREF _Toc9637883 \h 8

Error in medication PAGEREF _Toc9637884 \h 8

Misconduct PAGEREF _Toc9637885 \h 8

Misunderstood goals PAGEREF _Toc9637886 \h 8

Potential Barriers PAGEREF _Toc9637887 \h 9

Lack of practical approach PAGEREF _Toc9637888 \h 9

Cohesiveness PAGEREF _Toc9637889 \h 9

Objective Questions PAGEREF _Toc9637890 \h 9

Discussion PAGEREF _Toc9637891 \h 11

Conclusion PAGEREF _Toc9637892 \h 12

References PAGEREF _Toc9637893 \h 14

Clinical Mentoring Plan Report for mental health nursing


Adverse effects of drugs and errors in medication are termed as one of the major problems in the setting of a modern hospital, taking into account that it has a major effect on patient safety causing harm that may lead to mortality and morbidity. The stance of the adverse effect of drug is related to failure in adequate administration of drugs. It is evident and significant to note that the clinical other professionals that are working in mental health nursing are more towards patient care taking into account that minor negligence can cause serious complications. Mental health administrator is meant to serve as leader to provide better health opportunities along with administration of other actions that can have either a direct or indirect impact on the patient. It is asserted that there are a number of other fields of clinical setting that are empowered or influenced because of inadequate administration of medication such as the role of a runner, lack of comprehension of prescription etc. (Johnston, et, al. 2017). From last few years, it has been observed that the timeline of error in medication is much highlighted. There are a number of cases in which a patient is doomed to destruction and sometimes death just because of inadequate administration of medication. Such a scenario signifies the importance of administration of medication, especially in the realms of mental health where there is much danger as compared to other fields of healthcare. The purpose of this assignment is to create a clinical mentor plan for the administration of medicines in Mental Health Nursing, with an aim to inculcate strategies and objectives that could mitigate the errorful administration of drugs.

Structure of report

Literature Review

Research studies have highlighted that medication is termed as a primary therapy that could help a patient to recover and get back to a normal life. However, there is a relationship of care between the medicine user and nurses that aims at providing such necessities. It is asserted that medicines are administered in accordance with the stance of remedy practices taking into account that it is designed in such a way that all the needs of the patients are addressed. According to Bourke, (2016) there are a number of elements that are to be considered in order to address the administration of medication. It is important for a nurse to have a clear understanding of medicine that is to be given to the patient. There are certain ethics and frameworks to be followed in order to incorporate adequate administration of medicine. One of the prime aspects is the clear identification of the patients so that right entity is given required medicine. After that, a nurse must be well aware of the legal frameworks that are mandatory for keeping legislature enact. It is inferred that there are clear instructions regarding the route of administration, dose and the strength of the patient taking into account that all these formalities are fulfilled. (Bourke, et, al. 2016).

According to Damberg, (2013), it is asserted that there are certain dimensions that are associated with risky behaviour in the realms of mental healthcare. Along with the passage that involves the intervention of medicine, the management of medicine is also a major and critical subfield of drug management. (Damberg, et, al. 2013). It is important to note that a more diverse aspect of drug management highlight that there is a lack of involvement of patients in the drugs that are prescribed to a patient. Both these aspects pave the way for the fact that there is a difference in the management of drugs not only in clinical but in mental health care centres as well, taking into account that in Australia patient receive medication from a trolley that is actually placed near to nurses and other healthcare assistants so that a check and balance can be maintained. A systematic review, addressing medication safety has highlighted that in a number of mental hospitals, errors in medication has been one of the obvious observation. The impression of such errors is so strong that numerous patients are harmed because of it. The most critical aspect is, there is a lack of strong evidence that promotes these errors. However, numerous studies have highlighted that it is the knowledge gap that paves the way for such errors. In accordance with certain rough estimates, the rate of incidents reporting errors in medication may range from 3.3% to 48% involving all the cases of errors and mistaken behaviours. (Johnston, et, al. 2017).

Quantitative analysis is one of the major approaches that have been used to record the evidence related to medication errors and other complications that highlight gaps in the administration of medicines. It is significant to note that incident report reviews have also added to the body of knowledge taking into account that there is some concrete data that can be used to highlight concerns. An exegetical analysis infers that there is an imbalance of knowing or understanding in terms of runners and the disturbed patients that depicts the complete platform of errors. Lack of responsibility of runner and mismanagement of patients are termed as running heads they may contribute to the issue of unadministered medications. (Bourke, et, al. 2016).

Overview of mentee

My Mentee would be one of my colleagues. She has completed her undergraduate degree in nursing. She is registered to practice as a nurse in the mental health nursing. The prime areas to work during mentoring session would be professional growth and leadership attributes.

Overview of mentor and mentee baseline

Following is the code of conduct that would be utilized in order to achieve the desired goals

Mentor goals

Incorporate transitional leadership skills that can assert negotiation with patient

Incorporation of analytical skills so that a nurse can herself understand prescription and decision making

Administration of medication in terms of prescription to avoid errors in medication and consultation with a specialist

Route administration so that desired route of medication could be followed

Legislature information so that a nurse can abide by the legal framework in terms of healthcare

Anticipated Mentee Goals discussed

Understanding of basics of drug administration within mental health setting

Application of nursing and medication skills

Adaptation of leadership skills that can empower personality development

Understanding of setting to enhance decision making

Assumed Mentee Knowledge describes

Mentee is aware of a few legal adherences and frameworks that are applicable and mandatory in mental health nursing

Mentee has a clear understanding of drug administration and its certain dimension

She is aware of the importance of leadership skills that are necessary to achieve the desired healthcare goals

Contextual factors

There are a number of contextual factors that are to be considered in order to impart a clear understanding of the obligations that are necessary to achieve desired goals

Attention and focus

A nurse must always be attentive and she should have her prime focus strongly connected to the assigned task, taking into account that there is no space for negligence


Regulations assert that a nurse should abide by both setting and legal regulations so that desired results can be achieved. Regulations play a central role in the realms of mental health.

Patients as a priority

Mentee would be made clear that a patient should be treated on priority because it is one of the basic attributes of any healthcare setting.

Immediate Consultation

A nurse would be taught to opt for immediate consultation if she has any query, taking into account that any misunderstanding can risk the life of a patient.

Potential Difficulties

Following are the potential difficulties or barriers that can act as a hurdle in the achievement of desired goal

Lack of practical knowledge

Although mentee is well versed in terms of theoretical knowledge she lacks practical knowledge taking into account that there are numerous chances of negligence

Lack of opportunities to learn

As it is a mental healthcare centre with compact framework in which there is a set schedule of role distribution and assigned task so mentee would not be able to learn as a much as she could have learned in a flexible setting. Moreover, there are minimum options for self-actualization, taking into account a structural framework of practice.

Issues of time management

Time management is one of the greatest issues because mentee lacks practical knowledge and she would not be able to attain the level of expertise because of limited time frame.


Resources to be used are, PowerPoint presentation, handouts, note pad, example prescriptions, and stationery items

Outline of objectives

Learning and Practicing leadership skill such as communication and confidences

Learning administration of medication by analyzing routes of medication and prescription

Building and strengthening the relationship with patient’s for effective goal achievement

Issues and Challenges

Following are the issue and challenges that led to the formation set objectives

Error in medication

One of the major issues that empowered the formation of set objectives is the errors in medication, taking into account that there are a number of cases in which either there is an incorrect route or an incorrect medication. It is one of the issues that hamper and risk the lives of the patients.


Misconduct refers to the inability of a nurse in mental health to carry out her obligations with perfection because of lack of training and the other professional skills. It is a secondary issue that could affect the patient.

Misunderstood goals

Usually, there is misinterpretation in terms of both nurse and patients because of the lack of understanding of situation and discussion making power, taking into account that it is also concerned with passive relationship between patient and nurse. It refers to a common observation that patients don't feel comfortable, where it questions the reputation of the healthcare system.

Potential Barriers

There are a number of recent barriers that can affect the central goals of the mentoring plan

Lack of practical approach

There are two aspects of any practical framework, learning and application of learning. Learning is one of the easiest goals to be achieved while the practical application of whatever is being learnt is entirely dependent on the mentee. It can only be stressed but there is no way out to keep an accountability either these skills are applied or not in the long run.


Cohesiveness is one of the potential barriers that mitigate the set goals. It is significant to note that there is a lack of homogeneity in mental healthcare. If a nurse is willing to practice whatever he or she has learnt, it is entirely dependent on the measures of opportunities. Usually, lack of positive relationship with the other work fellows and with care specialist can lead to a highly uncertain and negative environment that affects everyone in that setting.

Questions for Mentee

Why is it important to adhere to leadership attributes in the mental health setting even when you have to keep patient at major priority

Level of question: This question is parallel to decision level, taking into account that it involves critical thinking that not only allows review and analysis of whatever is being learned but it direct new opportunities about what else can be done

How can you synchronize route of medications with the patient?

Level of question it is a reflective level question that can make a mentee recall whatever is learned and to use the most appropriate section. It is dependent on the use of factual information that can involve both feelings and facts.

How necessary do you think is the framework of adhering to the patient’s condition?

Level of question It is an interpretive level question that can help a mentee to adhere to meanings of the questions and the significance of issues that can direct certain decisions and actions.


Level of Question

Objective that is addressed

Why is it important to adhere to leadership attributes in the mental health setting even when you have to keep patient at major priority

Decision Level

Practical application and learning of leadership skills

How can you synchronize route of medications with the patient

Reflective Level

Administration of medication

How necessary do you think is the framework of adhering to the patient's condition?

Interpretive Level

Patient-nurse relationship and decision making


There are a number of benefits for mentee taking into account that she will be able to learn a number of new things after the completion of the mentoring plan. It is asserted that improvement of knowledge, skills and abilities would be one of the major attributes because the mentee will be exposed to an entirely new environment where she would learn new things such as analysis of the situations in terms of both patients and the assigned roles. She will come to know about the transition of roles because she has to help herself in different roles in accordance with situations. She will earn communication skills that will not only help her build her personality but it will add to her professionalism as well. Mentoring pan will make her learn to cater to the situation and be responsible in terms of any mismanagement. Career ability and promotion is another benefit that she will avail, taking into consideration that what matters is skill. She will be benefited from her professionalism because she will learn all the skills that can make her a good administrator.

It is important to note that she will have a clear understanding of her roles within the setting of mental health. The most evident difference that creates a line between mental health and other clinical setting asserting it is the ability of the nurse to determine what role is required of her. A nurse has to shift her role with changing situation, affirming that it is the only thing that can keep her going through all the situations successfully. (Bourke, et, al. 2016). A nurse has to be a human, a nurse and a responsible administer at the same time taking into account that a minor mistake can make her regret and threaten the life of a patient. Professionalism highlights a critical approach towards life where a nurse has to abide by all the relevant codes of the time, she has to adhere to the social, normative and culture association at the same time. She has to be clear about both written and unwritten rules and regulation because it can affect her progress as well as her responsibilities towards the organization. It would not be wrong to say that mentoring will help the mentee to overcome potential threats and failures because of her expertise in her work. She would have critical decision-making power that can pave the way for a supportive environment in which all successes and failures could be administered taking into account that any potential threat can be overcome.

Professional learning and experience is an evident product of the mentoring plan because practising and learning will make her give her best in any kind of setting. The mentoring plan will help her undergo an exegetical analysis of her abilities and other attributes that can pave the way for networking opportunities and opt for the best one. It is signified that the original crux of professionalism and duty rights is satisfaction, nurse will be confident about her actions and she would also be clear about the outcomes. (Kovess-masfety, et, al. 2017). Mentee would be able to reflect on her knowledge with efficiency and expertise because experimentation and practical approach towards theory will make her empower her team as well. She will not only be able to present herself as well as her organization and the team taking into consideration that mentoring plan will encourage a number of perspective and attitude that will reshape her knowledge and approach onwards professionalism. In a nutshell, it can be asserted that mentee would be able to learn all relevant skills and attributes that can make her develop professional approach in which all concerns would be addressed by analyzing the successes and failures adhering to the evaluation of situations and code of conduct in terms of non-confrontational manners and the expected responses.


Administration of medication is a diverse field that is associated with other fields of healthcare setting taking into account that it forms a complete department. In mental health setting, medication administration is associated with “runners”, “routine of medication” and the prescription in accordance with the patient and his ailment. It is one of the major schools of thought in mental health setting because there are mentally ill patient and any carelessness can lead to devastating results. In order to mitigate the increasing ratio of dilemmas that are associated with errors in medication and the increasing number of cases in which life is threatened because of minor careless, “administration of medication” was chosen as the topic of the report. The mentoring plan comprises of one of my colleagues as a mentee who will be taught about the strategies and objectives that can empower the administration of medication by overcoming the complications. It is significant to note that the primary objectives were to incorporate leadership skills, along with adequate channel of medication and a practical approach towards the administration of medication taking into account that the completion of this plan may lead to a professional entity who would be clear about her rights and the responsibilities where professionalism comes first.

The mentoring plan would facilitate active involvement in the setting of healthcare so that required results can be achieved within safe limits asserting effective role shifting and self-actualization that can help to be an adequate and valid decision. The mentoring plan highlights the areas to be considered while administrating education aims at a practical approach that can be incorporated for the achievement of required goals. However, the mentoring plan elaborates the edge between being a nurse and a human being taking into consideration that vision and perspective plays a significant role in the modification of rights and responsibilities that can adhere to the standards of setting. Due importance would be given to the surrounding where legislation plays a major role in determining what is required of a nurse. In a nutshell, it can be highlighted that the reports highlight all the features of an adequate mental health setting accompanied by an evaluation of professionalism that can determine roles and responsivities with respect to the need of the hour.


Bourke, T., Corkin, D., Cardwell, P., & Nugent, J. (2016). G622 IPE medicine management workshop. Archives of Disease in Childhood, 101(Suppl 1), A368.2-A368

Damberg, Cheryl L, Hiatt, Liisa., Chan, Kitty S., Nolind, Rebecca., & United States Agency for Healthcare Research Quality Content Provider. (2013). Evaluating the Feasibility of Developing National Outcomes Data Bases to Assist Patients with Making Treatment Decisions Data Bases to Assist Patients With Making Treatment Decisions. Santa Monica: RAND Corporation.

Johnston, Carolyn, & Liddle, Jane. (2017). The Mental Capacity Act 2005: A new framework for healthcare decision making. (LAW, ETHICS AND MEDICINE)(Author abstract). Journal of Medical Ethics, 33(2), 94-97.

Johnston, Carolyn, & Liddle, Jane. (2017). The Mental Capacity Act 2005: A new framework for healthcare decision making. (LAW, ETHICS AND MEDICINE)(Author abstract). Journal of Medical Ethics, 33(2), 94-97.

Kovess-masfety, Evans-lacko, Williams, Andrade, Benjet, Ten Have, . . . Gureje. (2017). The role of religious advisors in mental health care in the World Mental Health surveys. Social Psychiatry and Psychiatric Epidemiology, 52(3), 353-367.

Subject: Healthcare and Nursing

Pages: 10 Words: 3000

Assessment 3

Effective Workplace Culture Framework

[Name of Writer]

[Name of Institution]


Understanding the fact that workplace culture has a critical impact on the efficiency and reliability of healthcare provided is crucial. This is directly related to the idea that the environment within a healthcare facility defines the level of comfort patients as well as care providers feel. In an evolving atmosphere which also stays grounded and adhered to a certain set of unflinching values, the change automatically coupled with steady firmness gives birth to a balanced environment. This type of workplace culture allows for growth that matches changing societal values but also clings to certain basic rules regarding healthcare provision which makes it reliable and sturdy. It is extremely important that the workplace environment is friendly for its inhabitants within a healthcare provision facility because the degree to how effective the care provision is in achieving its goals depends on how at ease the stakeholders are. CITATION Sag18 \l 1033 (Sagha Zadeh, 2018)

The Effective Workplace Culture Framework, in its essence, employs the same principles in devising a comprehensive design of how the workplace environment in a healthcare facility should be fashioned. CITATION Man11 \l 1033 (Manley, 2011) There are four phases as part of the research carried out that stands behind the final look of this framework. The first phase outlies carrying out research to analyze the organizational culture from a corporate and managerial point of view. Observing the impact of the consultant nurse in providing quality care defines the first phase. The formation of an International Practice Development Colloqium forms phase two and three. While the second phase drafts the attributes, enabling factors and consequences, the third phase emulates extensive research to outline a meaningful critique of the findings of phase two. A shift from business culture to transformational culture had happened by that time and phase three embraces that premise to challenge the ideas established in phase two. Phase four involves informal critique of the framework as well as its practical use in real life healthcare provision settings.

The final look of the Effective Workplace Culture Framework therefore comes out as a combined result of the scientific work carried out in all four phases. According to the resolutions of this work, this framework is strictly people centered. Instead of focusing on monotonous duties, an effective workplace in a healthcare setting focuses on patients and other stakeholders which definitely involve care providers. The principles of continuous growth being balanced with steady base rules are also implemented. This framework hence successfully provides a very wide space and potential for learning and growth while also keeping the staff and the patients aware and stuck to fundamental policies of healthcare provision. There is also remarkable room for effective leadership qualities to form and flourish.

Themes and Analysis:

The first majorly recurring theme in the workplace environment with respect to healthcare is the problem of monotony and dreariness. One of the most common victims of this issue are geriatric nurses. In the global scenario of today, average lifespan is going up which inherently means there is a steady rise in the percentage of senior population in the world. This has been an especially remarkable issue in the global west. As the number of old people continues to grow, the demand for geriatric nurses automatically rises with it. CITATION Har19 \l 1033 (Harris, 2019) There are more old people in need of assistance and there is an infinitely higher chance of there being a rise in the number of old people with chronic diseases. The demand for geriatric nurses is therefore on a rise while the supply continues to fail in rising to the same standard. Even though the issue is obviously more complicated than an oversimplified generalization, a persistent theme of dull tedium in geriatric nursing is very telling. This issue of a glaring gap between the supply and demand of geriatric nurses has been repeatedly addressed. CITATION Ulu18 \l 1033 (Ulusoy, 2018) However, much of it circulates around the fact that monotony and boredom as well as an extremely restricted space for growth are some of the reasons why nurse students do not opt for geriatrics once they graduate. This problem of monotony in geriatric nursing can be helped and resolved through effective implementation of the Effective Workplace Culture Framework.

One of the most important attributes of the healthcare themed workplace as defined by the Effective Workplace Culture Framework is that it has an exceptional room for growth and learning. The framework decrees that the policies of an effective healthcare-related workplace should be centered around the comfort and the emotional as well as corporeal satisfaction of the people involved.

Another recurring theme in healthcare settings, also including geriatric nursing and its various sister fields, is the problem with not having a properly transformational leadership. In the context of nursing in general, it is vital to understand that in the rapidly progressing world of today, nursing and healthcare provision cannot be limited to a rigid, unflinching leadership. Transformational leadership provides nursing care with the hope of working towards achieving the ever-present goal of better care with reduced cost. In the nursing environment of today, transformational leadership unfortunately finds little to no practical footing. The only attention currently given to this concept is in the research driven literature on how healthcare provision can be improved to include the type of leadership that moves the system towards innovation rather than restricting it within the confines of classical policies and methodologies. CITATION Fis16 \l 1033 (Fischer, 2016) Like every other branch of nursing operating today, geriatric nursing also faces an acute lack of transformational leadership. It is quite apparent that the suffocating fence around growth, learning and evolution that nursing students feel with regard to geriatric nursing also relates with the fact that there is no practically transformational leadership in this nursing.

The nursing leaders and managers who successfully lead their staff to greater work-related satisfaction and an overall degree of fulfillment are crucial to the smooth sailing of this profession to greater innovation and progress. It should be vehemently reiterated that transformational leadership leads to greater job satisfaction in nurses. CITATION Boa18 \l 1033 (Boamah, 2018) Leaders who deliberately opt for changing policies with changing times and focus on the quality of care provided while contextually relating with the very specific challenges of that age are the need of the hour. Without the guidance of transformational leadership, nursing cannot fully achieve the economic balance that it has the potential to achieve. The qualities of transformational leadership can be taught and specifically inculcated in the nursing leadership at the vanguard of various sub-professions in nursing and healthcare provision. There are talks and research on forming the leaders of geriatric nursing because there is an acute need for progressive and innovative leadership in geriatrics. CITATION McB06 \l 1033 (McBride, 2006)

One other theme that can be readily addressed with regards to the Effective Workplace Framework is the fact that nursing fraternities are hesitant in having open communications and the proper sense of teamwork with them. The idea of a transparent management and interprofessional teamwork within the various types of healthcare providers is also unfortunately restricted to research-based literature. Nevertheless, it is an apparent fact that communication and teamwork within the various stakeholders who provide the patients with care is crucial. An introduction of better communication skills and a greater sense of teamwork within nurses and other healthcare practitioners can prove to bring several positive influences on the workplace environment in healthcare settings. There is greater job satisfaction as well as a greater degree of patient safety. The physical wellbeing of nurses is also benefitted through proper teamwork. CITATION Hel19 \l 1033 (Hellyar, 2019) In the current landscape there is reluctance in having an open and equally respectful relationship between several healthcare providers. Amidst physicians and nurses, there is an especially infamous antagonism. Most of this applies to geriatrics as well. Geriatric care is simply one of the several nursing professions where it is not common or endorsed to have completely open communication between healthcare practitioners. Neither is there enough incentive for interprofessional teamwork. Therefore, the implications of implementing this framework with regards to geriatrics are important. CITATION Cla15 \l 1033 (Clark, 2015)


The first recommendation is devising a people-centered policy via the Effective Workplace Culture Framework. If a workplace and its entire structure is based on making and implementing people-focused rules and regulations, the services provided in that workplace automatically becomes something that benefits the service providers as well as the service receivers. Once the focus shifts from completing monotonous tasks, for example those in the geriatric nursing facilities, and instead starts to focus on the actual patients and the quality of care they are to receive; there inherently forms a room for change and constant evolution. Then when a growth curve is attained through successful implementation of the Effective Workplace Framework, a large chunk of the current issues with geriatric nursing can be resolved. There is potential in incentivizing young nurse students to opt for geriatric nursing if they can be correctly convinced that it is, indeed, possible to grow, evolve and learn even in a nursing home for the older citizens. By countering monotony through abolishment of task-centered policy, the Effective Workplace Culture Framework establishes a people-centered policy which can serve to attract a greater number of nurses to geriatrics. It can even lead to a considerable decrease in the gap between supply and demand of geriatric nurses.

The second recommendation is that the framework should be used in devising and implementing a system with transformational leadership. Through proper and practically feasible implementation of the Effective Workplace Culture Framework, it is automatically understood that the leadership involved in this scenario will be transformational. Establishing and expanding a room for growth and change cannot be done while having the old system intact and having its policies still have an impact. Another bonus advantage of including transformational leadership as part of the Effective Workplace Culture Framework in geriatric nursing is the fact that it can reduce the static outlook of the job. It will henceforth have a convincing case with respect to attracting young nursing students towards geriatrics.


BIBLIOGRAPHY Boamah, S. A. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 180-189.

Clark, P. G. (2015). Emerging themes in using narrative in geriatric care: Implications for patient-centered practice and interprofessional teamwork. Journal of aging studies, 177-182.

Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of Advanced Nursing, 2644-2653.

Harris, J. (2019). Geriatric Trends Facing Nursing with the Growing Aging. Critical Care Nursing Clinics , 211-224.

Hellyar, M. M. (2019). Case Study Investigation Decreases Burnout While Improving Interprofessional Teamwork, Nurse Satisfaction, and Patient Safety. Critical Care Nursing Quarterly, 96-105.

Manley, K. S. (2011). Effective workplace culture: the attributes, enabling factors and consequences of a new concept. International Practice Development Journal, 1-29.

McBride, A. B. (2006). Developing geriatric nursing leaders via an annual leadership conference. Nursing Outlook, 226-230.

Sagha Zadeh, R. S. (2018). The Importance of Specific Workplace Environment Characteristics for Maximum Health and Performance. Journal of occupational and environmental medicine, e245-e252.

Ulusoy, N. W. (2018). Psychosocial burden and strains in geriatric nursing: comparison of nursing personnel with and without migration background. Zeitschrift fur Gerontologie und Geriatrie.

Subject: Healthcare and Nursing

Pages: 6 Words: 1800

Assessment 3

Old Age Fall and Its Consequences

Submitted by



Old Age Fall and Its Consequences

Old age always brings with it a lot of health problems. As a result, an older adult is no longer able to take care of himself. His family often do not have enough time for proper care. Besides, in many cases, professional knowledge and experience are needed. Therefore, the nurse is often the optimal solution for the older man. To ensure quality care, a nurse for senior citizens should have high professional qualities. It is required to know the basic care methods for various diseases of an age-related nature. Also, he becomes for his ward and assistant at home and just a friend with whom you can always talk, and older people often really lack communication and care.

Case study

Mrs H., 83, lived independently in a small terraced house on the outskirts of a small town. For a long time, however, she feels increasingly unsteady on her legs. When she gets up quickly or turns from the stove to the fridge, she suddenly becomes dizzy. She has already fallen several times at home but luckily no injuries except for an abrasion and a bruise on the buttocks. The family doctor has not been consulted, "because nothing bad has happened". And he advises a nurse who can take care of her. Mrs H. withdraws increasingly and is depressed.

The nurse leaves her only very rarely. Fearful of falling again, Ms H. avoids the stairs to the first floor, where the bedroom is located. Instead, she prefers to sleep in the living room on the couch. Unintentionally, Mrs H. accelerates, with their behaviour, the age-related muscle breakdown and the restriction of the range of motion further reduces their overall functional level. Under the mobility restriction also suffers the diet. Since the nearest supermarket is about 800 meters away, shopping can only rarely be done. A neighbour would be willing to go shopping for Mrs H., but she is uncomfortable asking for it. So she feeds mainly on soup soups because she is no longer hungry anyway because of the diminished movement. The restriction of movement increasingly neglects the once well-maintained rooms. When a distant niece comes to visit, she is appalled by the "dismantling" and neglected state of the house and urges Mrs H. to move to a nursing home.

Features of the treatment and recovery of older people after fractures

Old age is not a joy: this proverb humbles each of us with the thought that many problems inevitably accompany old age. First of all, of course, we are talking about health problems, which over the years are mostly progressing. However, a responsible attitude to their well-being can significantly facilitate the life of an elderly person. So, one of the most common reasons for seeking emergency medical care in people over 60 is a fracture. What is the reason for brittle bones in a person in old age, and what are the consequences of injuries of this kind, discussed in this assignment?

Why the risk of fractures increases in old age?

A fall can be a dramatic event, especially for an older adult, that marks the beginning of a downward spiral that ends in endangering independent living. In a fall, however, not only can the bones break, but the self-confidence in one's own motor skills also diminishes. This leads to an avoidance behaviour with a progressive loss of other abilities. In order to be able to prevent this downward spiral effectively, the identification of endangered patients and goal-oriented prevention are crucial in order to contain existing risk factors.

As the body ages, metabolic processes slow down, as does the ability to regenerate - the natural restoration of damage. As a result, people of advanced age develop osteoporosis - a progressive decrease in bone density. Just as the logs from which the wooden house is built begin to dry out over time, and the entire structure settles under its own weight, retirees have a decrease in growth, stoop, pathological curvature of the spine and so-called hypo traumatic fractures that occur with minor injuries or sudden movements. Another risk factor for fractures in older people is weakness and dizziness, which may be the result of concomitant chronic diseases (for example, heart and vascular diseases). As a result, it is easy to lose balance and fall on a slippery road or get hurt when doing everyday household chores such as cleaning or hygiene.

The consequences of fractures for the elderly

It would seem that fractures do not carry any danger. But nurses have long learned how to heal bones, and painkillers relieve the patient's suffering at all stages of recovery. However, in old age, the disease proceeds differently, and even a "harmless" injury can lead to death. One of the reasons is that the bones of people in old age grow together much more slowly than in youth. It is due to a decrease in metabolism and blood supply to skeletal tissue.

The second problem is related to the immobilization (temporary immobilization) of the damaged part of the body. It often mandatory bed rest (with a fracture of the femoral neck or vertebrae). The lack of movement weakens the body and negatively affects the emotional state of an older adult: many patients bedridden become indifferent to their health, complain of helplessness and do not believe in the possibility of recovery (Buerhaus, Skinner, Auerbach & Staiger,2017). Another danger is associated with thromboembolism; it is a decrease in the patient's mobility contributes to the formation of blood clots in the vessels of the lower extremities. That subsequently threatens to block the pulmonary artery - a deadly condition. According to statistics, one in four people who break a hip neck dies from the consequences of a fracture within six months. 90% of femoral neck fractures occur after 65 years (Bergen, 2016).

How is the treatment of fractures of different localisation in elderly people?

For an older person to have broken bones, they often have to resort to surgical intervention. We are talking about osteosynthesis, in which the fragments are connected by a metal plate, and in some cases, on joint replacement, in which the bone joint is entirely replaced by the implant. The problem with this approach is that not all people of age are able to undergo surgery safely, so the question of its advisability is decided on an individual basis. But it is not enough to return the skeleton to its "initial state" - it is essential that the patient begins to move in the same volume. After fractures, patients noticeably weaken, lose muscle mass and, much more dangerous, motivation for an active life. So, many older people who have broken the neck of the femur quickly learn to use a wheelchair and are sceptical of rehabilitation courses aimed at restoring the ability to walk independently. Therefore, it is essential, even at the stage of treatment planning, to think about selecting qualified rehabilitation specialists who will help "bring to mind" the work of a traumatologist and surgeon.

Radial Fractures in the Distal Section

The most common type of fracture of the upper limb is usually observed when falling on an arm extended posture. In uncomplicated cases, the split treated by applying a plaster cast (or polymer bandage). If there is a displacement of bone fragments or if the doctor suspects that the process of their fusion will be complicated, the patient has spokes. The treatment process takes approximately six weeks, after which the patient needs rehabilitation - exercises aimed at restoring the muscle strength of the damaged arm.

Fracture of the surgical neck

A relatively common type of injury that occurs in adults is when they fell from a height with a sharp jerk. In mild cases, the fractures without displacement, the treatment target in fixing the hand with a special bandage. If the bone fragments are separated, they are combined under local anaesthesia or a procedure for skeletal traction. In severe cases, the patient undergoes surgery with the application of plates. However, it may be contraindicated for debilitated patients. The period of immobilization is an average of 6 weeks; in the future, the patient needs rehabilitation aimed at restoring the functions of the damaged limb.

Supracondylar and condyle fractures

These fractures are diagnosed with injuries of the elbow, usually with falls on the arm. Treatment consists in the application of gypsum and a bandage holding the arm; in severe cases, the patient may require skeletal traction of the arm or surgery. Plaster must be worn for about six weeks. Rehabilitation as with other types of arm fractures.

Hip fractures

The thigh neck is the thinnest place in the bone that is poorly supplied with blood, so fractures in this area heal together for a very long time. As a rule, in older people, they occur when falling from their height. Such fractures require surgical treatment - osteosynthesis with a pin, knitting needle, plate, etc. or replacement of the femoral head or the entire joint. Postoperative hospitalization takes several days, while the rehabilitation period requires many months of hard physical therapy, physiotherapy and other activities aimed at restoring the mobility of a weak limb.

Fracture trochanteric fractures

Trochanteric fractures are common in the elderly due to osteoporosis. The femur grows together extremely slowly; therefore, if possible, patients undergo surgery aimed at combining fragments or replacing the hip joint. Recovery after a fracture and surgery takes six months or more. Patients need help with everyday activities, hygiene, cooking, and so on. Often it is necessary to adapt to the patient's home in a particular way, considering his weakness and inactivity.

Fractures of the tibial condyles

A fracture occurs during knee injuries, for example, when falling on bent legs. Such a fracture may be accompanied by bleeding in the cavity of the knee joint. Depending on the severity of the bone damage, the patient is given gypsum, knitting needles (Ilizarov apparatus), or surgery is performed with the installation of screws or plates. Full recovery of the limb after a fracture takes about six months. Throughout this period, the patient should undergo rehabilitation measures - physiotherapy, massage, etc.

Ankle fractures

They are diagnosed due to tucking of the legs or falling of an older person on a tucked leg. For older people with ankle fractures, a plaster cast is applied with a particular metal “stirrup” at the bottom, which makes it possible to lean on a sore leg without using a crutch. Fracture healing in uncomplicated cases takes about two months. Rehabilitation is aimed at restoring healthy gait and preventing lameness. It is necessary to lead a mobile lifestyle, engage in physical education; regular yoga classes are useful. Another essential prevention factor is proper nutrition, which includes the recommended dose of vitamin D (10 mcg per day), calcium (at least 700 mg) and refusal to drink alcohol. The first is found in sea fish, and especially its liver, in dairy products, butter, oatmeal and potatoes, while the second is abundant in cottage cheese, cheese, yoghurt, all kinds of cabbage, spinach, nuts, tofu. Do not neglect the intake of vitamin and mineral complexes to strengthen bones and immunity. Besides, it is useful for people of age to breathe fresh air daily and to walk more, increasing muscle mass. And the interest in life and attention from relatives will help them get away from depressive thoughts associated with ageing and avoid many health problems. At any age, bone fractures require not only proper and timely treatment but also a rehabilitation period. It is especially crucial for the elderly, who are much more difficult to recover than the young. At the end of the rehabilitation measures, standardized preventive measures for repeated fractures will require.

The well-being of cares and the work community needs to be improved

According to the doctoral study, elder abuse was more common in workplaces with a weak atmosphere. In their replies, nurses reported cases where workplace controversies seen as part of the mistreatment of the elderly. According to Miller (2018), the stress of nurses does not explain the more severe cases, but the mental and social abuse. The nurse may scream or punch something, or she may not be able to behave correctly. One way to improve well-being at work could be to increase work guidance. According to his experience, it is little uses in elderly services compared to, for example, psychiatry. (Miller, 2018).


If relevant risk factors have been identified, these should be targeted. The exhaustion of resources, e.g., social support, information to the patient on local offerings for age-appropriate training programs, fall prevention strategies and increased sensitivity to home-made fall-triggers, as well as the targeted improvement of motor skills, are the basis for avoiding future falls.

The installation of hand grips, as well as the removal of tripping hazards in the home environment and optimization of the lighting, can reduce the risk of falling, especially in persons at risk of falling (Mostaghel, 2016). Also useful is the change of footwear to sturdy shoes with non-slip sole. In the case of falls accompanying cardiovascular diseases, such as tachyarrhythmias, a hypersensitive carotid sinus or a vasovagal syndrome, then the patient should be referred to a cardiologist or clinic for further diagnosis and therapy. The implantation of a pacemaker can help prevent future falls when indicated. Whether the assessment of visual impairment by an evaluation and a single intervention brings a reduction of the risk of falling, is still controversial.


Bergen, G. (2016). Falls and fall injuries among adults aged≥ 65 years—United States, 2014.

MMWR. Morbidity and mortality weekly report, 65.

Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four challenges facing

the nursing workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46.

Miller, C. A. (2018). Nursing for wellness in older adults. Lippincott Williams & Wilkins.

Mostaghel, R. (2016). Innovation and technology for the elderly: Systematic literature review.

Journal of Business Research, 69(11), 4896-4900.

Subject: Healthcare and Nursing

Pages: 8 Words: 2400

Assessment Article Picot

PICOT Question

[Name of Writer]

[Name of Institution]

PICOT Question:

In foreign patients who do not speak English, how do regular nursing rounds influence communication over the course of their stay at the hospital?

Article 1:

Permalink: http://ezproxy.acu.edu:3058/ehost/detail/detail?vid=0&sid=3c09f3c3-b9d8-4be2-abe4-f2d100a4338f%40pdc-v-sessmgr04&bdata=JkF1dGhUeXBlPXNzbyZzaXRlPWVob3N0LWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=103772321&db=ccm CITATION Bri15 \l 1033 (Bright, 2015)

Summary: The primary author of this study is Felicity Bright from the School of Rehabilitation and Occupation Studies at ACT University in Auckland. This is a review that mainly focuses on understanding how current literature has influenced the meaning and the need for clear communication between patients and their healthcare providers especially when it comes to rehabilitation. The researchers conducted a literature search using EBSCO and SCOPUS databases to reach the conclusion that clinicians and healthcare providers play a significant role in the engagement required for quality care provision.

Application: The review answers the PICOT question by establishing a relationship between effective communication with patients by placing the responsibility on healthcare providers or nurses. In conservative settings, this responsibility is generally on patients only but especially, considering our question, if the patients speak a foreign language; it is on the nurses to devise strategies for an effective engagement over concerns.

Article 2:

Permalink: http://ezproxy.acu.edu:3058/ehost/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46bZMta%2b0Ua6k63nn5Kx95uXxjL6vrVGtqK5Jt5awUrCmuE2xls5lpOrweezp33vy3%2b2G59q7SbGmr06wqrJOtZzqeezdu33snOJ6u9nrfeLjpIzf3btZzJzfhruotFC1rrdKt5zkh%2fDj34y73POE6urjkPIA&vid=0&sid=065eb0ad-8d90-4bd9-bd2a-87054e948e75@pdc-v-sessmgr01 CITATION Dan16 \l 1033 (Daniels, 2016)

Summary: This study has been conducted by Juli Daniels from the JBI affiliated institute at University of California in San Francisco. The study aims to establish hourly or otherwise regular nursing rounds as an effective strategy for improving direct communication with the patient about potential health concerns that the patient might have. Researchers used interventions at a healthcare facility in America to compare results in the form of patient engagement and successful communication with patients with and without regular hourly nursing rounds. Data from before and after interventions was collected and was statistically analyzed to find significant differences between the two. Results were therefore indicative of hourly nursing rounds to be an efficient strategy in improving communications with patients.

Application: The results of this study directly answer our PICOT question. Regular nursing rounds can create an environment of trust where the patients would be more likely to communicate. This will also be especially helpful for patients with language barriers. Nurses can use these rounds to contribute to better patient safety and greater degree of patient satisfaction.

Article 3:

Permalink: http://ezproxy.acu.edu:2674/ehost/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46bZMta%2b0Ua6k63nn5Kx95uXxjL6vrVGtqK5Jt5awUrOvuEqzls5lpOrweezp33vy3%2b2G59q7SbCmtFCurrNMsZzqeezdu33snOJ6u9nhhaTq33%2b7t8w%2b3%2bS7SbGmt1Gxr69LpNztiuvX8lXk6%2bqE8tv2jAAA&vid=0&sid=f3ef5c0c-61ec-41c5-99e6-a53d58c1b312@sessionmgr4006 CITATION Pel18 \l 1033 (Peled, 2018)

Summary: This is a study conducted by Yael Peled from the Institute for Health and Social Policy at McGill University in Montreal. The author has conducted a thorough literature search to find a relationship between linguistic barriers and the problems in efficient healthcare provision that arise from it. Despite education of empathy and compassion in nursing schools, it is still normal that a nurse can misinterpret the mannerisms of a language they cannot speak. This can unfortunately lead to severe miscommunications between the nurse and the patient hence causing injustice or subconscious bias in the care that a foreign language-speaking patient might receive from the nurse. The author addresses the problem and has devised the solution of arousing metalinguistic awareness and humility in the nurses concerning the language they themselves speak.

Application: This article also relates effectively with our PICOT question since it raises the issue of the extent of linguistic barriers in nursing. The article provides key insight into how far the influence of a linguistic barrier can go and therefore it legitimizes the core problem of our PICOT question. It is the idea that the issue of linguistic barriers causes serious communication problems that can be addressed using frequent and orderly nursing rounds.

Article 4:

Permalink: http://ezproxy.acu.edu:3058/ehost/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46bZMta%2b0Ua6k63nn5Kx95uXxjL6vrVGtqK5Jt5axUq%2bquEmzls5lpOrweezp33vy3%2b2G59q7Ra%2but0u1q69RtKukhN%2fk5VXj5KR84LPhhePa6z7y1%2bVVv8SkeeyzsUivqbZPrqakfu3o63nys%2bSN6uLyffbq&vid=0&sid=5be0b2ea-a8ca-46a3-92dd-e6e79cae3a83@pdc-v-sessmgr06 CITATION Shi18 \l 1033 (Shin, 2018)

Summary: The primary author of this study is Shin Nayeon who is from the Department of Nursing at Bundang CHA Hospital in Seongnam. This is a research article that was published following a study conducted with interventions of regularly timed nursing rounds with gaps of two to three hours. Before the interventions were practically carried out in a healthcare facility, the researchers devised six principles including knowing, being with, maintaining belief, enabling, doing for and patient’s wellness. They obtained the relevant scales for quantifying these principles from the Nursing Care Scale as well as a questionnaire to gauge patient’s satisfaction with the nursing care being provided to them. Results provided confirmation of a significant relationship between nursing rounds and quality of nursing care as well as betterment in patient satisfaction.

Application: By virtue of quantitatively asserting the statistical significance of regular nursing rounds for better communication with patients, this research article relates to our PICOT question. Our question searches for an answer to whether regular and frequent nursing rounds can be effective in making communication with patients better. The article proves the authenticity of our question and provides an answer to it.

Article 5:

Permalink: http://ezproxy.acu.edu:3058/ehost/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46bZMta%2b0Ua6k63nn5Kx95uXxjL6vrVGtqK5Jt5axUq%2bquEmzls5lpOrweezp33vy3%2b2G59q7TLaotkuzqbdIpOLfhuWz44ak2uBV4dnrPvLX5VW%2fxKR57LOvSLGvsEmyrLc%2b5OXwhd%2fqu37z4uqM4%2b7y&vid=0&sid=dbfc2248-e4ee-4eea-8a18-2dee271bb893@sessionmgr102 CITATION Rei14 \l 1033 (Reimer, 2014)

Summary: The primary author for this literature-based study is Nicole Reimer who is from the Institute of Epidemiology at the Friedrich-Loeffler-Institut in the Isle of Riems. The authors of this study have conducted a wide literature search over several methods of conducting nursing rounds and the overall influence of those methods on the patient satisfaction as well as quality of care that is provided to the patient. There are several types of rounds that were implemented in a hematology/oncology unit to be assessed for this study. Researchers ensured daily rounds by unit educator and unit manager, interdisciplinary collaborative rounds, rounds by senior nursing managers and senior executives as well as patient rounds. Outcomes of all these rounds were found to be positive.

Application: This literature review has application in finding an answer to our PICOT question since the importance of nursing rounds is being emphasized as cause for improvement in patient satisfaction and safety. The study establishes the fact that these improvements happen because of a better communication and understanding of trust between the patient and their healthcare provider. Therefore, a correlation between nursing rounds and better direct communication with patients is invariably confirmed.

Article 6:

Permalink: http://ezproxy.acu.edu:3058/ehost/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46bZMta%2b0Ua6k63nn5Kx95uXxjL6vrVGtqK5Jt5axUq%2bquEmzls5lpOrweezp33vy3%2b2G59q7RbSpsU%2bwprZQtJzqeezdu33snOJ6u9nrfeLjpIzf3btZzJzfhruotVGyprFOs5zkh%2fDj34y73POE6urjkPIA&vid=0&sid=8d3b3296-f4b6-4172-90b2-35223b382bea@pdc-v-sessmgr05 CITATION Gar17 \l 1033 (Garone, 2017)

Summary: The primary author of this study is Anja Garone who is from the Department of Linguistics at Vrije Universiteit Brussel in Brussels. This is also a literature-based study that looks at the importance of linguistic synchronization in nursing and its implications. As the world moves towards greater globalization and there is a positive emphasis on diversity and acceptance; the idea of only one language for nursing can lead to problems especially with patients not accustomed to communicating in the lingua franca. Globalization and internalization have created a situation where it is pivotal for nurses to be able to successfully interact with patients belonging to a multitude of languages and cultures. This study emphasizes on the use of CLIL (content and language integrated learning) in nursing programs to help soothe linguistic barriers between nurses and patients.

Application: This literature review directly talks about linguistic barriers between patients and nurses. Our PICOT question is all about suggesting a strategy to improve communication between patients and nurses when the two do not happen to converse in the same language. The study therefore maintains the fact that linguistic barriers drastically affect patient-nurse communication.

Article 7:

Permalink: http://ezproxy.acu.edu:2674/ehost/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46bZMta%2b0Ua6k63nn5Kx95uXxjL6vrVGtqK5Jt5ayUq6tuEqyls5lpOrweezp33vy3%2b2G59q7Sbeot1CyrrJJsJzqeezdu33snOJ6u9nhhaTq33%2b7t8w%2b3%2bS7Sa6rsEyyqbFIpNztiuvX8lXk6%2bqE8tv2jAAA&vid=0&sid=44534331-3323-4209-a775-05e2e0f94576@sdc-v-sessmgr01 CITATION Car09 \l 1033 (Carnevale, 2009)

Summary: The primary author for this study is Franco Carnevale who is Assistant Director at the Ingram School of Nursing of McGill University in Montreal. This is a review article that is based on extensive literature search for the various serious ethical concerns around the linguistic barriers between nurses and their patients. The researchers found from their literature search that the major ethical concern with nurses and their patients speaking different languages is the fact that this can negatively influence the standard of healthcare provided to the patient and hence become the cause of discrimination. Researchers consulted the code of ethics laid out in the Canadian Nurses Association, the American Nurses Association and the International Council of Nurses. Their ethical concerns were confirmed.

Application: Our PICOT question demands a solution to the problem of poor communication with foreign patients who do not speak or understand English. In order to properly look for a solution such as nursing rounds, it is first significant to authorize that the problem is significant and validated enough. This literature study does that. By highlighting the ethical problems arising from linguistic barriers in nursing, this study confirms that there is a significant communication loss between nurses and patients due to a different language.

Article 8:

Permalink: http://ezproxy.acu.edu:3058/ehost/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46bZMta%2b0Ua6k63nn5Kx95uXxjL6vrVGtqK5Jt5ayUrCruEyvls5lpOrweezp33vy3%2b2G59q7Ra%2bvtE6wqrRMsqukhN%2fk5VXj5KR84LPhhePa6z7y1%2bVVv8SkeeyzsEyyqbZMsqykfu3o63nys%2bSN6uLyffbq&vid=0&sid=3e37cead-bbc0-4904-b4f1-7d56f881b22c@pdc-v-sessmgr01 CITATION Fab15 \l 1033 (Fabry, 2015)

Summary: The author of this study is Donna Fabry who is from the School of Nursing at the State University of New York in Amherst. This is an article based on a survey that was conducted on nursing staff at six healthcare facilities. The unique purpose of this study was to gauge the influence of regular nursing rounds on the nursing staff. This is in correlation to the already researched idea that patient safety and satisfaction rates are higher with nursing rounds. This study observed the influence of these rounds on the nursing staff. Most of the results obtained from this study concluded that deriving satisfaction from nursing rounds varied across the different job descriptions of various nurses.

Application: This study is also important for our PICOT question because this is a different take on the nursing rounds that we have presented in our question. Since the communication that is so vital in our question is two-way and involves both nurses and patients, it is important to understand that nursing rounds benefit nurses as well.


BIBLIOGRAPHY Bright, F. A. (2015). A conceptual review of engagement in healthcare and rehabilitation. Disability and rehabilitation, 643-654.

Carnevale, F. A.-B. (2009). Ethical considerations in cross-linguistic nursing. Nursing Ethics, 813-826.

Daniels, J. F. (2016). Purposeful and timely nursing rounds: a best practice implementation project. JBI database of systematic reviews and implementation reports, 248-261.

Fabry, D. (2015). Hourly rounding: perspectives and perceptions of the frontline nursing staff. Journal of nursing management, 200-210.

Garone, A. &. (2017). The role of language skills and internationalization in nursing degree programmes: A literature review. Nurse education today, 140-144.

Peled, Y. (2018). Language barriers and epistemic injustice in healthcare settings. Bioethics, 360-367.

Reimer, N. &. (2014). Round and round we go: rounding strategies to impact exemplary professional practice. Clinical journal of oncology nursing, 654-660.

Shin, N. &. (2018). The Effect of Intentional Nursing Rounds Based on the Care Model on Patients' Perceived Nursing Quality and their Satisfaction with Nursing Services. Asian nursing research, 203-208.

Subject: Healthcare and Nursing

Pages: 5 Words: 1500

Assessment – Written Report CHCPOL003 Research And Apply Evidence To Practice

Title: Written report CHCPOL003 Research and apply evidence to practice

Student Name:

Name of Institution:

Hand Washing Practices in Aged Care:


Human beings are always at risk of exposure to dangerous diseases that could really harm us and even result in mortality. This is especially even more true for people who are much older and aged. Their immunity and ability to fight diseases is far less and leaves them open to any number of diseases. This is why in aged care and aged care homes it is imperative to keep a healthy sterile environment. This can easily be done by small acts such as washing hands, which reduces the chances of outbreak of healthcare associated infections. This report researches this notion and tries to work out if handwashing reduce transmitting of infections.

Areas Where Research Can Improve Infection Prevention:

While caring for the aged, medical professionals generally use gloves to minimise the risk of exposure to the healthcare professional or to the patient to any sort of bacteria or virus that can cause harm to their biological system. But putting on gloves is not enough as there are still millions of bacteria and viruses carried around by the human body. So to effectively reduce any chance of infection, handwashing can be used before and between donning of gloves. This will reduce risk of infection and reduce prolonged stays in hospitals.

Reason for Undertaking Research:

The primary reason for taking on this research is to clarify how a simple act of handwashing can be useful towards disease prevention. People in aged care are already not strong enough to take care of themselves but if proper care and attention is not given to them they might not survive. By simply following a habit of handwashing while doing any sort of activity that is related to them will help them to feel secure and maintain their health.


The hypothesis that is going to be tested in this research paper is of determining that chances of transmission of diseases will occur less if hands are washed between donning of gloves during aged care compared to changing of gloves without properly washing hands.

Research Objective:

The objective to be achieved by this research is to find the degree to which washing hands before and between donning gloves will affect the rate of transmission of infections compared to not washing hands between donning gloves. The report will focus on this objective and research on literature evidence to support the outcome. These objectives will be accomplished when evidence will be fully collected to overhemly support either sides.

Other Connected Discipline:

This research is focused on whether handwashing between donning gloves can reduce chance of infection compared to donning gloves without it. This research can be modified and used to determine the validity of different brands of soap and handwash to determine which one is better at killing bacteria. This modified research would help to determine the truthfulness of the marketing strategy used to sell these different types of products and provide an assessment based on actual scientific research.

Literature Search:

The literary work behind the importance of handwashing between donning of gloves compared to not washing them at all is extensive. For the purpose of this only two sources were selected, which will be used to support the hypothesis stated above. These sources are as follows:

Hand Hygiene Practices in a Neonatal Intensive Care Unit: A Multimodal Intervention and Impact on Nosocomial Infection: https://pediatrics.aappublications.org/content/pediatrics/114/5/e565.full.pdf

According to this source, healthcare associated infections have become a dominating problem in most neonatal intensive care units. This is accredited to low implementation of hand hygiene policy making hand hygiene as the major cause for increasing spread rate of infections among patients and doctors. This study then looked at how much contact patients had with their caregivers and the compliance of healthcare professionals to hand hygiene policy.

Role of Hand Hygiene in Healthcare-Associated Infection Prevention https://www.journalofhospitalinfection.com/article/S0195-6701(09)00186-8/pdf

According to this study, healthcare workers are the major transporters of healthcare related infections by not washing their hands . They then come into contact with a variety of patients and get them infected within the healthcare environment. So healthcare professionals using medical equipment without properly washing their hands is becoming the leading cause of infectious disease spread. But their compliance to hand hygiene is also considered as the best measure towards prevention of spread of anti-bacterial or microbial resistance.

Methods for Data Collection:

Data for this research would be collected from a combination of different materials and sources. Firstly, data would be collected from existing literature. This would be helpful because it will provide a basis for the research and the research would be able to evolve using it as a basis. This is because there has already been so much work done related to the hypothesis being tested in this paper, which can help this research to gain credibility. Second method of data collection would be interviews and surveys. These are important because they are done for a more specific reason and have an human element to it. This will allow the readers of this research to connect with the data collected and will have an immense impact on their thinking leading them to changing their normal behaviour. Lastly, search engines with specific keywords such as Web-of-science and BIOSIS search engines would be used to get research specific information.

Systematic Approach to Data Collection:

The systematic approach to data collection determines the research’s viability. This is done by application of clearly defined steps based on experience and to evaluate the outcome of the steps taken. This is done to generate consistent optimal results. In this research, a systematic approach towards compiling information has been used. This is evident from the use of authenticated literature to support and advance our hypothesis being tested in this research.


According to the Allegranzi and Pittet (2009), the most common form of transference of diseases is through the hands of Health care professionals. They have access to a variety of different types of diseases in their normal work hours. This means they have to extra careful with their hygiene and use proper sterilised medical tools so that they do not inturn hurt the patients they are trying to take care of. They should be vigilant and keep their body neat and clean before exchanging words or checking out a patient. Especially, they need to be aware of the fact of how much bacteria and other viral diseases can linger around for a long period of time. So hygiene maintenance including hand washing should be their habit and go to action before any interaction with any type of patient. Hospitals need to administer firmly the hygiene code on each and every employee. This will keep the doctors on high alert against slacking off regarding their hygiene especially washing their hands before putting on gloves to see patients. Even after knowing how much danger healthcare professionals put their patients at by not washing their hands and keeping a healthy hygiene, the compliance ratio to optimal hygiene conditions has been low. Their can be several reasons for this low compliance ratio such as most health care professionals are over worked, with long hours and limited sleep that at a certain point they might not have the mindset to properly adhere to every code and ethic regarding their profession. This can be very detrimental for the patient if his healthcare provider does not care to adhere to a small activity such as washing hands before meeting him. Whereas, a study conducted by Lam (2004), observed the ratio of compliance to hygiene standards such as handwashing and nature of patient contacts in neonatal intensive care units. To do this the study focused on observing the patient contacts, hand hygiene compliance and healthcare professionals hand washing techniques. As the study progressed it was found that through hand hygiene education hand hygiene compliance increased for before patient contact as well as after patient contact. Even more progress was seen towards high risk procedures and this all accumulated into a factor for decreasing health care associated infection rate. This research if used correctly can be used to educate a number of healthcare professionals of the benefit of hand hygiene and without any doubt will be deciding factor behind mortality rates from infectious diseases. Health hygiene education should definitely be provided to aged care workers as they interact with people who have low immunity to fight common everyday diseases.


Hence, it is imperative that hand hygiene compliance should be made mandatory and should be done before any interaction with patients especially those who are aged. Before any checkup or procedure hand hygiene should be maintained to the highest degree. The data collected through literature, search engines and other sources clearly support the hypothesis. The data also clearly supports the hypothesis and relates the rise of hospital related infectious diseases to a lack of compliance towards medical entities hand hygiene compliance policies. As more and more health care professionals were educated regarding its dangers the degree of infection related deaths became less and less.


Allegranzi, B. and Pittet, D. (2009). Role of hand hygiene in healthcare-associated infection prevention. Journal of Hospital Infection, 73(4), pp.305-315.

Lam, B. (2004). Hand Hygiene Practices in a Neonatal Intensive Care Unit: A Multimodal Intervention and Impact on Nosocomial Infection. PEDIATRICS, 114(5), pp.e565-e571.

Subject: Healthcare and Nursing

Pages: 5 Words: 1500


Assessment Findings

[Author’s name]

[Institute’s name]

Assessment Findings

Development of Genogram and Ecomap

Summary of Family and Community Assessment Data

           Comprehensive understanding of the health concerns at family and community levels is essential to accomplish some particular objectives in an effective manner. Consideration of the specific Leading Health Indicator (LHI) according to the actual approach of the specific community is an essential step to identify the actual health issues of the people of that community. The approach of LHI can be used to determine actual influence of a particular health concern and how it can be minimized through necessary practical measures. Here, the main focus is to select the suitable LHI according to the healthcare requirement of the Hispanic community that regionally belongs to San Bernardino County.

           Case study of a sixty-one years old Hispanic female is one of the specific cases that can be used to critically examine the healthcare domain in the context of community and family assessment. It is vital to critically examine the overall daily routine of her life to make better inferences about her health condition. This form of observation further assists to identify the most suitable healthcare approach in the form of Leading Health Indicator (LHI). The framework of LHI is of utmost importance as it provides valuable data to figure out the health condition of an individual. This certain paradigm is assistive to define the areas that require necessary and immediate improvement.

           In the first step of the detailed assessment of the community and family health, it is important to examine the overall lifestyle of the Hispanic female. Interview is a practical approach in this case to closely examine her way of life and figure out how it negatively influencing her health. It is observed that the old Hispanic female of 189 Ibs is suffering from the chronic issue of hypertension. This specific concern prevails for her due to different inter-connected reasons. It is critical to examine all relevant aspects to ensure the significant form of proper healthcare assessment at the family and community level. Examination of her routine perspectives reveals that she is not greatly connecting with her immediate family members. Her kids hardly visit her place where she lives alone and manages all things by herself. It is a complex situation as these aspects eventually impact her mental health condition. The issue of hypertension is going to be adverse for her with time and it appears that she requires immediate community healthcare needs to tackle the concern. Her main health issue in the form of hypertension can determine through the specific Leading Healthcare Indicator.

           The health issue in case of the Hispanic community can also better understand through the consideration of other critical details about the life of an old Hispanic female. The objective of extensive information about the considered lady can be achieved through the proper development of the tools of genogram and ecomap. The aim of these two forms of visual representation is to examine the crucial information of the considered individual. She is a financially strong woman as she never has any issue to pay her utility bills. Furthermore, she never had great social interaction with her family and community as she only had some friends in Church where she plays her role very actively.

Selection of Theories

Self-Care Deficit Nursing Theory

           The self-care deficit nursing theory is recognized as a theory that closely linked with the domain of community health. It is the direction for nursing staff to ensure the provision of better healthcare assistance to the patients at community level. The focus of this theoretical framework is to assist people to better handle the approach of self-care by embracing the requirements of the environment ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"5MltJnH6","properties":{"formattedCitation":"(Smith & Parker, 2015)","plainCitation":"(Smith & Parker, 2015)","noteIndex":0},"citationItems":[{"id":14,"uris":["http://zotero.org/users/local/qLzeF6Hj/items/X3K54ZWW"],"uri":["http://zotero.org/users/local/qLzeF6Hj/items/X3K54ZWW"],"itemData":{"id":14,"type":"book","title":"Nursing theories and nursing practice","publisher":"FA Davis","ISBN":"0-8036-4224-5","author":[{"family":"Smith","given":"Marlaine C."},{"family":"Parker","given":"Marilyn E."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Smith & Parker, 2015). It is comprised of the concept to consider humans being able to flexibly adjust with their environment. This specific theory contains some forms of strengths and limitations that need to be considered when it comes to application. Consideration of different intellectual and practical phases is the major strength of this theoretical approach, whereas the limitation is that it never fully covers each aspect of the nursing paradigm. There is a need for more clarity when it comes to defining the role of the family to assist the patient. The implications of this theory in the form of nursing practice can better examine in case of community healthcare service. The role of nursing staff is immensely critical to ensure the overall well-being of the Hispanic female who is going through with different physical damages and the major concern of hypertension.

Human Needs Theory

           Human needs theory established as one significant form of non-nursing theories that can be applied at the social level to ensure better approach of individual behavior. Maslow provides the direction in case of basic human needs through the approach of the pyramid. This kind of realization further helps to examine the actual necessities prevails in case of social framework. Hierarchy of needs plays a vital role to determine the importance of each need for human beings in the social set-up. The theoretical framework of human needs theory is linked with the approach of family/community healthcare. Consideration of the basic needs is the crucial step to promote better healthcare domain in people by aligning their behavioral domains. Identification of advantages and restrictions of this specific theory is also primitive to ensure the proper application according to the requirement of the situation. The main advantage of this theoretical spectrum is that is comprised of the domain of nature of human beings ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4LX2RRTA","properties":{"formattedCitation":"(Moreno, Zidarov, Raju, Boruff, & Ahmed, 2017)","plainCitation":"(Moreno, Zidarov, Raju, Boruff, & Ahmed, 2017)","noteIndex":0},"citationItems":[{"id":15,"uris":["http://zotero.org/users/local/qLzeF6Hj/items/DVNKW4GJ"],"uri":["http://zotero.org/users/local/qLzeF6Hj/items/DVNKW4GJ"],"itemData":{"id":15,"type":"article-journal","title":"Integrating the perspectives of individuals with spinal cord injuries, their family caregivers and healthcare professionals from the time of rehabilitation admission to community reintegration: protocol for a scoping study on SCI needs","container-title":"BMJ open","page":"e014331","volume":"7","issue":"8","author":[{"family":"Moreno","given":"Alexander"},{"family":"Zidarov","given":"Diana"},{"family":"Raju","given":"Chandhana"},{"family":"Boruff","given":"Jill"},{"family":"Ahmed","given":"Sara"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Moreno, Zidarov, Raju, Boruff, & Ahmed, 2017). On the other hand, the limitation of this theory is that it is closely linked with the cultural paradigms and differently apply in different cultural environments. The paradigm of human needs theory can be assistive for the nursing staff to examine the actual psychological position of the patient in the form of a particular behavior.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Moreno, A., Zidarov, D., Raju, C., Boruff, J., & Ahmed, S. (2017). Integrating the perspectives of individuals with spinal cord injuries, their family caregivers and healthcare professionals from the time of rehabilitation admission to community reintegration: Protocol for a scoping study on SCI needs. BMJ Open, 7(8), e014331.

Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice. FA Davis.

Subject: Healthcare and Nursing

Pages: 3 Words: 900

Assessment Of Community-Level Barriers



Assessment of Community-Level Barriers


Institutional Affiliation(s)

Author Note

Assessment of Community-Level Barriers

The African American community is faced with a number of issues concerning the Human Immunodeficiency Virus (HIV). The community lacks adequate education about HIVs symptoms, risks and causes in general while there are little awareness programs available for the community. Nearly half of the community remains undiagnosed of the condition until it reaches its last stage (Edward, 2019). To address some of these issues, a community level program was proposed that would help spread HIV awareness by conducting helpful sessions that target the African American population suffering from HIV. Additionally, the barriers to HIV treatment and interventions to address these barriers are examined alongside noting ethical, regulatory, and accreditation requirements for the program.

Recap of the Model Program

The program will involve People with HIV (PLHIV) to register themselves in support groups in order to obtain critical psychological help. These support groups will involve sharing experiences, enhancing coping skills of patients, encouraging disclosure, improving their psychosocial functioning, reducing stigmatization, and assisting them in medication adherence. The program will particularly target pregnant women, couples, and men who have sex with men (MSM) within the African American community (Bateganya, Amanyeiwe, Roxo, Dong, 2016). The program will further involve conducting fundraising galas on a yearly basis that will collect funds to offer financial help to individuals who cannot afford medication and treatment. HIV tests would be further conducted on a regular basis, working alongside healthcare professionals, and patients would be recommended with appropriate care plans, while setting up telephone assistance helplines to aid HIV patients in case of an emergency (Mcallon, 2018).

Critical Barriers to Wellbeing

A number of barriers impede progress in eliminating the HIV endemic among the African American community. At the micro level, financial barriers serve as a major obstacle since antiretroviral drug therapy remains expensive while patients with immune systems compromised require longer and, thus, costly treatment at hospitals. In addition, private health insurance market is rife with inequalities and discrimination against individuals diagnosed with HIV either by limiting coverage, charging higher premiums, or screening them for pre-existing conditions (Paying for Healthcare, 2019).

Secondly at the macro-level, barriers that reduce access to appropriate care include social and structural factors which impact the African American community at the wider level. A lack of access to adequate prevention and treatment services stems from institutionalized discrimination, lower socio-economic status, a general lack of social support, and HIV-associated stigma. Inequalities in healthcare funding as well as welfare support for families together contribute to these barriers wherein race intersects with gender, sexuality, and poverty to create social exclusion and disadvantage for the community (Geter, Sutton, McCree, 2018).

Another critical barrier in this regard is geography which contributes to HIV-associated disparities among the African-American community. The geographical factor occurs as a result of regional disparities and residential segregation which raises the burden of disease on the marginalized community. In particular dense urban poverty areas with a substantial black population are less likely to receive HIV treatment and prevention services owing to the environmental and geographical stressors of the neighborhood (Meditz, et al., 2011). The remoteness of these neighborhoods from quality screening services and an overall higher community viral load means that an Individual from this location has a higher chance of contracting the disease from the same behavior compared to an individual hailing from a more affluent neighborhood.

Interventions and Solutions to Address Barriers

At the micro-level, public payer programs are necessary to bear the medical costs of the community members suffering from HIV. This involves expanding Medicaid and Medicare coverage to include the affected population without limiting benefits for antiretroviral therapies and other co-morbidity treatment costs. Furthermore, universal health coverage should be encouraged under an Integrated health system that provides HIV treatment, diagnosis, and prevention services at the community level (Robinson Moodie-Mills, 2012). In this regard, supporting the Affordable Care Act is important to ensure adequate access to care and insurance coverage for African Americans suffering from HIV.

To address structural and social barriers at the macro-level, it is important to train physicians in engaging patients from ethnic and racial minorities in an empowering and non-stigmatizing way. Additionally, culturally appropriate care and active follow-ups would reduce social stigmatization and encourage African American individuals to seek treatment and strengthen their engagement with health services. Funding should be directed to expanding research on the intersection of various structural factors that increase risk among the communitys sexual networks and use the research to inform policies (Geter, Sutton, McCree, 2018). Additional funding should be directed to addressing the communitys unmet needs such as employment, housing, or childcare by increasing social and peer support.

Furthermore, housing opportunities for individuals with AIDs should be provided by funding and facilitating stable housing as a preventive step. Any intimidation and discrimination with regards to housing on the basis of ethnicity, gender identity, or sexual orientation should be prohibited alongside providing appropriate investigative power to law enforcement in this regard (Robinson Moodie-Mills, 2012).

Ethical, Accreditation, and Regulatory Requirements

The legal environment, state regulations, and federal policies considerably influence a communitys access to HIV-associated services and programs. In this respect, non-discrimination provisions bar any form of discrimination against marginalized or vulnerable populations in order to encourage individuals to seeks HIV-associated services more openly. These provisions ensure that our program will remain open and accessible to the entire community. In addition, the program involves testing and financing HIV treatments, which would require adhering to confidentiality requirements. Any participants in the program should be notified of their right to confidentiality to comply with federal regulations and gain their trust. Disclosures can only be made in exception to medical personnel in case a particular condition immediately threatens the health of the programs participant (CSAT, 2000).

Since the program encourages African-American community members for screening, it is ethically and legally mandatory to receive informed consent from them or someone authorized to consent on behalf of them. It would involve advising the participant with sufficient information regarding the HIV-related test (NY Gov, 2015). Furthermore, Individuals conducting the HIV tests are ethically responsible to conduct it in adherence with quality management system principles and ensure the highest accuracy and quality. The testing sites should be accredited by an appropriate authority and providers should meet regulatory standards with regards to training and testing SOPs to perform the procedure (WHO, 2015).

Finally, since the program involves fundraising, it is important to accredit it as a community foundation by the NSCF. This would involve submitting assessment documentation to confirm that all requirements are met according to the National Standards, and including the registered charity number, address, and company name in all promotional materials (Gonzalez, 2019). This would, in turn, provide donors with confidence in the programs operations and ensure transparency in the program.


Bateganya, M., Amanyeiwe, U., Roxo, U., Dong, M. (2016). The Impact of Support Groups for People Living with HIV on Clinical Outcomes a systematic review of the literature. Journal of acquired immune deficiency syndromes, 680(0-3), S368-S374. doi10.10972FQAI.0000000000000519

CSAT. (2000). Substance Abuse Treatment for Persons with HIV/AIDS. Rockville, MD Center for Substance Abuse Treatment.

Edward, S. (2019). Who Is at Risk for HIV Infection and Which Populations Are Most Affected National Institute on Drug Abuse, 21-34.

Geter, A., Sutton, M. Y., McCree, D. H. (2018). Social and structural determinants of HIV treatment and care among black women living with HIV infection a systematic review 20052016. AIDS Care, 30(4), 409-416. doi10.10802F09540121.2018.1426827

Gonzalez, C. (2019). National standards for u.s. community foundations. Retrieved July 3, 2019, from Council on Foundations https//www.cof.org/national-standards-us-community-foundations

Mcallon, J. (2018). HIV Programs Services. Regional HIV/AIDS Connection, 190-198.

Meditz, A., MaWhinney, S., Allshouse, A., Feser, W., Markowitz, M., Little, S., . . . Collier, A. (2011). Sex, race, and geographic region influence clinical outcomes following primary HIV-1 infection. The Journal of infectious diseases, 203(4), 442-451.

NY Gov. (2015). HIV Related Testing. Retrieved July 4, 2019, from New York Department of Health https//www.health.ny.gov/diseases/aids/providers/regulations/testing/section_2781.htm

Paying for Healthcare. (2019). In Chapter 5.1. Ashford.

Robinson, R., Moodie-Mills, A. C. (2012). HIV/AIDS Inequality Structural Barriers to Prevention, Treatment, and Care in Communities of Color. Berkeley, CA Center for American Progress.

WHO. (2015). Consolidated Guidelines on(IJUX

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Subject: Healthcare and Nursing

Pages: 3 Words: 900

Assessment Of Knowledge, Practice And Satisfaction Of Health Care Services Rendered By Community Health Workers Among Health Care Consumers.

Assessment of Knowledge, Practice, and Satisfaction of Health

Care Services Rendered by Community

Health Workers among Health Care Consumers



Author Note


TOC \o "1-3" \h \z \u Abbreviations PAGEREF _Toc15830320 \h 3

Introduction and Background PAGEREF _Toc15830321 \h 6

Research Rationale PAGEREF _Toc15830322 \h 9

Research Objective PAGEREF _Toc15830323 \h 10

Significance of Research PAGEREF _Toc15830324 \h 10

Literature Review PAGEREF _Toc15830325 \h 11

Research Methodology PAGEREF _Toc15830326 \h 13

Study Area PAGEREF _Toc15830327 \h 13

Study Population PAGEREF _Toc15830328 \h 13

Study Duration PAGEREF _Toc15830329 \h 13

Sampling Method PAGEREF _Toc15830330 \h 14

Sample Size PAGEREF _Toc15830331 \h 14

Study Tools PAGEREF _Toc15830332 \h 15

Data Analysis PAGEREF _Toc15830333 \h 15

Observations and Findings PAGEREF _Toc15830334 \h 15

Discussion and Conclusion PAGEREF _Toc15830335 \h 16

Salient Recommendations PAGEREF _Toc15830336 \h 17

Summary PAGEREF _Toc15830337 \h 19

References PAGEREF _Toc15830338 \h 20





Community-Based Organization


Community Health Centre


Community Health Worker


Comprehensive Primary Health Care


Department of Health


Directly Observed Therapy


Diagnostic Statistical Manual


General Practitioner


Health in All Policies


Human Immunodeficiency Syndrome


Identity document


Integrated Development Plan


Key Informant Interviews


Non-Governmental Organization


Non-Profit Organization


Primary Health Care


Post-Traumatic Stress Disorder


Reconstruction and Development Programme


Social Determinants of Health


Voluntary Counselling & Testing


World Health Organization

Assessment of Knowledge, Practice, and Satisfaction of

Health Care Services Rendered by

Community Health Workers among Health Care Consumers


Community health workers are placed in a unique position to bridge gaps between communities and the health care sector. The strength of their relationship with both the community they serve and the healthcare department only boosts their level of motivation and performance. This study aims at the assessment of knowledge, practice, and satisfaction of health care services rendered by community health workers among health care consumers in the post-Katrina city of New Orleans, Louisiana. The study shows a complex interplay of the influence of trust and the relationship community members have with community health workers. Furthermore, it aims to analyze how useful their efforts were in rehabilitating the healthcare infrastructure in a post-hurricane New Orleans. This was a cross-sectional survey. It employed the use of multistage sampling and used a mix of quantitative and qualitative methods. The quantitative data obtained was analyzed using XL Stat while qualitative data was analyzed in a thematic manner.

Introduction and Background

Navigating healthcare systems in challenging, especially with patients with lack of information about their ailment, language barrier, or various other problems ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VIMJvKfx","properties":{"formattedCitation":"(Osae-Larbi, 2016)","plainCitation":"(Osae-Larbi, 2016)","noteIndex":0},"citationItems":[{"id":"nT7X3s8k/G3aF5mGB","uris":["http://zotero.org/users/local/0omESN17/items/QHU37MFQ"],"uri":["http://zotero.org/users/local/0omESN17/items/QHU37MFQ"],"itemData":{"id":672,"type":"book","title":"Bridging the language barrier gap in the health of multicultural societies: report of a proposed mobile phone-based intervention using Ghana as an example","publisher":"Springer","ISBN":"2193-1801","author":[{"family":"Osae-Larbi","given":"Judith Ansaa"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Osae-Larbi, 2016). This includes ways to understand and manage chronic diseases like diabetes, cancer, or heart diseases. Collectively known as health literacy, it improves patient’s knowledge about disease management, management of prescription drugs and how to prepare for appointment ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"sbhUwYXU","properties":{"formattedCitation":"(De Wit et al., 2018)","plainCitation":"(De Wit et al., 2018)","noteIndex":0},"citationItems":[{"id":"nT7X3s8k/bfSXMFnH","uris":["http://zotero.org/users/local/0omESN17/items/48S3P4JT"],"uri":["http://zotero.org/users/local/0omESN17/items/48S3P4JT"],"itemData":{"id":673,"type":"article-journal","title":"Community-based initiatives improving critical health literacy: a systematic review and meta-synthesis of qualitative evidence","container-title":"BMC public health","page":"40","volume":"18","issue":"1","author":[{"family":"De Wit","given":"Liesbeth"},{"family":"Fenenga","given":"Christine"},{"family":"Giammarchi","given":"Cinzia"},{"family":"Di Furia","given":"Lucia"},{"family":"Hutter","given":"Inge"},{"family":"Winter","given":"Andrea","non-dropping-particle":"de"},{"family":"Meijering","given":"Louise"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (De Wit et al., 2018). In order to improve health literacy among patients, healthcare centers often collaborate with community health workers.

The community health workers serve as a bridge between primary healthcare providers and healthcare consumer ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"gezpaild","properties":{"formattedCitation":"(Javanparast, Windle, Freeman, & Baum, 2018)","plainCitation":"(Javanparast, Windle, Freeman, & Baum, 2018)","noteIndex":0},"citationItems":[{"id":"nT7X3s8k/SkeabcR3","uris":["http://zotero.org/users/local/0omESN17/items/8M5RMD6X"],"uri":["http://zotero.org/users/local/0omESN17/items/8M5RMD6X"],"itemData":{"id":674,"type":"article-journal","title":"Community health worker programs to improve healthcare access and equity: Are they only relevant to low-and middle-income countries?","container-title":"International journal of health policy and management","page":"943","volume":"7","issue":"10","author":[{"family":"Javanparast","given":"Sara"},{"family":"Windle","given":"Alice"},{"family":"Freeman","given":"Toby"},{"family":"Baum","given":"Fran"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Javanparast, Windle, Freeman, & Baum, 2018). In this instance, the primary healthcare providers are the doctors and the nurses that tend to your issues at a primary care facility, with the patients and their families serving as the healthcare consumer ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Cfs2ILGg","properties":{"formattedCitation":"(Javanparast et al., 2018)","plainCitation":"(Javanparast et al., 2018)","noteIndex":0},"citationItems":[{"id":"nT7X3s8k/SkeabcR3","uris":["http://zotero.org/users/local/0omESN17/items/8M5RMD6X"],"uri":["http://zotero.org/users/local/0omESN17/items/8M5RMD6X"],"itemData":{"id":674,"type":"article-journal","title":"Community health worker programs to improve healthcare access and equity: Are they only relevant to low-and middle-income countries?","container-title":"International journal of health policy and management","page":"943","volume":"7","issue":"10","author":[{"family":"Javanparast","given":"Sara"},{"family":"Windle","given":"Alice"},{"family":"Freeman","given":"Toby"},{"family":"Baum","given":"Fran"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Javanparast et al., 2018). Research has shown has hiring community health workers to be a part of community health care teams helps overcome a number of challenges, which leads to better access to care, increased compliance, increased quality of care and reduced costs ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"XEkdWObx","properties":{"formattedCitation":"(Mohajer & Singh, 2018)","plainCitation":"(Mohajer & Singh, 2018)","noteIndex":0},"citationItems":[{"id":"nT7X3s8k/M4n6DLvX","uris":["http://zotero.org/users/local/0omESN17/items/B3VDA68W"],"uri":["http://zotero.org/users/local/0omESN17/items/B3VDA68W"],"itemData":{"id":675,"type":"article-journal","title":"Factors enabling community health workers and volunteers to overcome socio-cultural barriers to behaviour change: meta-synthesis using the concept of social capital","container-title":"Human resources for health","page":"63","volume":"16","issue":"1","author":[{"family":"Mohajer","given":"Nicole"},{"family":"Singh","given":"Debra"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mohajer & Singh, 2018).

This history of community health workers in the USA goes way back. It is long, varied and has served to be a rallying voice with the American Public Health Association, back in the 1970s ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LSzN7FFN","properties":{"formattedCitation":"(APHA, 2018)","plainCitation":"(APHA, 2018)","noteIndex":0},"citationItems":[{"id":"nT7X3s8k/ivFT8Hjv","uris":["http://zotero.org/users/local/0omESN17/items/ZH4XZGCS"],"uri":["http://zotero.org/users/local/0omESN17/items/ZH4XZGCS"],"itemData":{"id":669,"type":"webpage","title":"Community Health Workers","container-title":"American Public Health Association","URL":"https://www.apha.org/apha-communities/member-sections/community-health-workers","author":[{"family":"APHA","given":""}],"issued":{"date-parts":[["2018"]]},"accessed":{"date-parts":[["2019",7,26]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (APHA, 2018). It is an old, reliable, and robust institute that often serves as the backbone of the healthcare services being provided by these workers in the community. They have contributed to the system in diverse ways, making it more efficient and effective. They have brought more individuals into the fold by allowing more individuals to have access to the care they need just where they need it and how they needed it. The operations undertaken by community health workers have made the jobs of both the primary health care providers, as well as the families of patients easier. Community health workers offer insight, along with services that address the scope of the health care model.

The activities undertaken by community health workers include a wide variety of areas that require attention. It includes creating a more effective and positive linkage between the communities as well as the healthcare system. They are tasked with impact health education, along with information, to various parts of the community. These messages are imparted in a culturally appropriate way which resonates with their ideals and moral values of the community. Attention to such small details makes it easier for the community to absorb the information being relayed by the community health worker, increasing the chances of the advice being followed. Such programs, according to another study, reduce the need to see costly specialists and lead to a nationwide cost savings of around 60 billion dollars.

With most people still unaware of what universal health coverage entails, a community health worker is tasked with organizing and mobilizing communities to help them look after their own health. They have a vital role in universal health coverage by making it more accessible to the masses. This promotes the idea of better health within the community and enables the preventive measures that keep them healthy. This is done through the intake of nutritious and healthy food options. They make preventive measures possible for the members of the community which keeps the need for a cure at bay ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"tlZi6wSd","properties":{"formattedCitation":"(Mohajer & Singh, 2018)","plainCitation":"(Mohajer & Singh, 2018)","noteIndex":0},"citationItems":[{"id":"nT7X3s8k/M4n6DLvX","uris":["http://zotero.org/users/local/0omESN17/items/B3VDA68W"],"uri":["http://zotero.org/users/local/0omESN17/items/B3VDA68W"],"itemData":{"id":675,"type":"article-journal","title":"Factors enabling community health workers and volunteers to overcome socio-cultural barriers to behaviour change: meta-synthesis using the concept of social capital","container-title":"Human resources for health","page":"63","volume":"16","issue":"1","author":[{"family":"Mohajer","given":"Nicole"},{"family":"Singh","given":"Debra"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mohajer & Singh, 2018). This exhibits that the issues of promoting health and preventing diseases in a community are key in community health services and first-line curative services. It allows a basic streamlining of the process at hand so that the time of a healthcare provider is properly utilized. It gives them room to focus on people requiring special care and attention while the community health workers ensure that the community has measures in place to deal with such ailments ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4mMAu0ha","properties":{"formattedCitation":"(Allen, McBride, Balcazar, & Kaphingst, 2016)","plainCitation":"(Allen, McBride, Balcazar, & Kaphingst, 2016)","noteIndex":0},"citationItems":[{"id":"nT7X3s8k/f0dOzBwK","uris":["http://zotero.org/users/local/0omESN17/items/58XRKNK7"],"uri":["http://zotero.org/users/local/0omESN17/items/58XRKNK7"],"itemData":{"id":676,"type":"article-journal","title":"Community health workers: an untapped resource to promote genomic literacy","container-title":"Journal of health communication","page":"25-29","volume":"21","issue":"sup2","author":[{"family":"Allen","given":"Caitlin G."},{"family":"McBride","given":"Colleen M."},{"family":"Balcazar","given":"Hector G."},{"family":"Kaphingst","given":"Kim A."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Allen, McBride, Balcazar, & Kaphingst, 2016).

One of the finest examples of how fruitful community health workers proved for New Orleans, Louisiana following the devastating affects of Hurricane Katrina. Hurricane Katrina was the single most catastrophic natural disaster in the history of the USA ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"hzJNikm6","properties":{"formattedCitation":"(FEMA, 2006)","plainCitation":"(FEMA, 2006)","noteIndex":0},"citationItems":[{"id":386,"uris":["http://zotero.org/users/local/5VyEEXyp/items/NFT3E9XW"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/NFT3E9XW"],"itemData":{"id":386,"type":"article","title":"Hurricane Katrina in the Gulf Coast","publisher":"Federal Emergency Management Agency","URL":"https://www.fema.gov/media-library-data/20130726-1520-20490-4067/549_cvr_toc.pdf","author":[{"family":"FEMA","given":""}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (FEMA, 2006). It ushered in a storm of such magnitude that the state of Louisiana and its healthcare system has yet to recover from its devastating effects ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"bJlN3iMt","properties":{"formattedCitation":"(Mammoser, 2017)","plainCitation":"(Mammoser, 2017)","noteIndex":0},"citationItems":[{"id":387,"uris":["http://zotero.org/users/local/5VyEEXyp/items/4JAKET7P"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/4JAKET7P"],"itemData":{"id":387,"type":"webpage","title":"Louisiana’s Healthcare System","container-title":"Healthline","URL":"https://www.healthline.com/health-news/why-is-louisianas-healthcare-so-bad#1","author":[{"family":"Mammoser","given":"Gigen"}],"issued":{"date-parts":[["2017",8,22]]},"accessed":{"date-parts":[["2019",7,28]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mammoser, 2017). However, no city was hit worse than New Orleans. The population is mostly African American, and the city had one of the country’s highest percentage of uninsured individuals among the population. These people relied on the Charity Hospital System for care ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"vvh9pzKS","properties":{"formattedCitation":"(Rudowitz, Rowland, & Shartzer, 2006)","plainCitation":"(Rudowitz, Rowland, & Shartzer, 2006)","noteIndex":0},"citationItems":[{"id":391,"uris":["http://zotero.org/users/local/5VyEEXyp/items/J738JPYP"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/J738JPYP"],"itemData":{"id":391,"type":"article-journal","title":"Health Care In New Orleans Before And After Hurricane Katrina: The storm of 2005 exposed problems that had existed for years and made solutions more complex and difficult to obtain.","container-title":"Health Affairs","page":"W393-W406","volume":"25","issue":"Suppl1","author":[{"family":"Rudowitz","given":"Robin"},{"family":"Rowland","given":"Diane"},{"family":"Shartzer","given":"Adele"}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Rudowitz, Rowland, & Shartzer, 2006). When Katrina devastated the New Orleans healthcare safety net, it completely changed the healthcare landscape of the city. It left many without access to healthcare for over a year, with local officials struggling to rebuild the city ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1cBejeFG","properties":{"formattedCitation":"(Rudowitz et al., 2006)","plainCitation":"(Rudowitz et al., 2006)","noteIndex":0},"citationItems":[{"id":391,"uris":["http://zotero.org/users/local/5VyEEXyp/items/J738JPYP"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/J738JPYP"],"itemData":{"id":391,"type":"article-journal","title":"Health Care In New Orleans Before And After Hurricane Katrina: The storm of 2005 exposed problems that had existed for years and made solutions more complex and difficult to obtain.","container-title":"Health Affairs","page":"W393-W406","volume":"25","issue":"Suppl1","author":[{"family":"Rudowitz","given":"Robin"},{"family":"Rowland","given":"Diane"},{"family":"Shartzer","given":"Adele"}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Rudowitz et al., 2006).

According to the Census held in 2000, Louisiana is the poorest of all US states. It has the largest percentage of population with incomes that is rather low than the federal poverty level, i.e. $16,090 for a family of three. This percentage includes 22% of the population of the entire state of Louisiana, 23% of which is concentrated in New Orleans alone ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0xyfBtmF","properties":{"formattedCitation":"(Morial, 2007)","plainCitation":"(Morial, 2007)","noteIndex":0},"citationItems":[{"id":440,"uris":["http://zotero.org/users/local/5VyEEXyp/items/7NFM3HVI"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/7NFM3HVI"],"itemData":{"id":440,"type":"article-journal","title":"Katrina: Health Care System Recovery, Reform, and Renaissance","container-title":"The Permanente Journal","page":"66","volume":"11","issue":"4","author":[{"family":"Morial","given":"Julie C."}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Morial, 2007). Furthermore, about 25% of the population in Louisiana did not have access to health insurance, even prior to Katrina. This number is equivalent to 900,000 residents of the state and is considered equal to about 15% population of California. Couple that in with low-rates of employer-sponsored coverage, most people do not seek medical assistance until its to late. This also showed the deplorable state of Louisiana in terms of healthcare network available to the masses ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"xDLjEgoE","properties":{"formattedCitation":"(Morial, 2007)","plainCitation":"(Morial, 2007)","noteIndex":0},"citationItems":[{"id":440,"uris":["http://zotero.org/users/local/5VyEEXyp/items/7NFM3HVI"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/7NFM3HVI"],"itemData":{"id":440,"type":"article-journal","title":"Katrina: Health Care System Recovery, Reform, and Renaissance","container-title":"The Permanente Journal","page":"66","volume":"11","issue":"4","author":[{"family":"Morial","given":"Julie C."}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Morial, 2007).

This system was reformed by community health workers, giving healthcare to those caught in the middle of unprecedented devastation and urgent need of healthcare. The hurricane left more than 1,577 people dead in Louisiana alone, with even more suffering from direct physical health problems as a result of the hurricane. To make the situation even worse, countless were unable to access medical care they needed or the prescription drugs they required to deal with pre-existing conditions, or new conditions that formed as a result of hurricane ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"udnnx6IW","properties":{"formattedCitation":"(Huelskoetter, 2015)","plainCitation":"(Huelskoetter, 2015)","noteIndex":0},"citationItems":[{"id":441,"uris":["http://zotero.org/users/local/5VyEEXyp/items/GCX3BNYN"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/GCX3BNYN"],"itemData":{"id":441,"type":"webpage","title":"Hurricane Katrina’s Health Care Legacy","container-title":"Center for American Progress","abstract":"Gulf Coast states must expand Medicaid under the Affordable Care Act to address the long-term consequences of the federal government’s failed health policy response to Hurricane Katrina.","URL":"https://www.americanprogress.org/issues/healthcare/reports/2015/08/20/119670/hurricane-katrinas-health-care-legacy/","language":"en-US","author":[{"family":"Huelskoetter","given":"Thomas"}],"issued":{"date-parts":[["2015",8,20]]},"accessed":{"date-parts":[["2019",8,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Huelskoetter, 2015). Two years after the storm, a survey by FEMA discovered that the people still present in the area suffered through a weakening of their physical and mental health. As compared to adults, children were four times as likely to be implicated by the after effects of the disaster. While more care is needed to this day to improve the situation and make it better than what it was before ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"YQdjSfMb","properties":{"formattedCitation":"(Griffies, 2010)","plainCitation":"(Griffies, 2010)","noteIndex":0},"citationItems":[{"id":443,"uris":["http://zotero.org/users/local/5VyEEXyp/items/RBQ3FM37"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/RBQ3FM37"],"itemData":{"id":443,"type":"article-journal","title":"Health Care Infrastructure Post-Katrina: Disaster Planning to Return Health Care Workers to Their Home Communities","container-title":"Psychiatric Services","page":"70-73","volume":"61","issue":"1","source":"ps.psychiatryonline.org (Atypon)","DOI":"10.1176/ps.2010.61.1.70","ISSN":"1075-2730","title-short":"Health Care Infrastructure Post-Katrina","journalAbbreviation":"PS","author":[{"family":"Griffies","given":"W. Scott"}],"issued":{"date-parts":[["2010",1,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Griffies, 2010), community health workers were nothing short of being heaven-sent for the residents of the area. They worked alongside first responders and helped wherever they can, in just about every possibility that they possibly could ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Hi9XGu3z","properties":{"formattedCitation":"(Wennerstrom et al., 2011)","plainCitation":"(Wennerstrom et al., 2011)","noteIndex":0},"citationItems":[{"id":392,"uris":["http://zotero.org/users/local/5VyEEXyp/items/75GD3KBY"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/75GD3KBY"],"itemData":{"id":392,"type":"article-journal","title":"Community-based participatory development of a community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans","container-title":"Ethnicity & disease","page":"S1","volume":"21","issue":"3 0 1","author":[{"family":"Wennerstrom","given":"Ashley"},{"family":"Vannoy","given":"Steven D."},{"family":"Allen","given":"Charles E."},{"family":"Meyers","given":"Diana"},{"family":"O'Toole","given":"Elizabeth"},{"family":"Wells","given":"Kenneth B."},{"family":"Springgate","given":"Benjamin F."}],"issued":{"date-parts":[["2011"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Wennerstrom et al., 2011).

Research Rationale

Community health workers were a huge support in dealing with Post-Katrina New Orleans. Not only did the help the healthcare providers with the patients, but they also allowed the healthcare system to vastly improve in short among of time. They not only physically helped the people but also helped them improve their mental health but getting them the care they needed ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"emec7V2D","properties":{"formattedCitation":"(Wennerstrom et al., 2011)","plainCitation":"(Wennerstrom et al., 2011)","noteIndex":0},"citationItems":[{"id":392,"uris":["http://zotero.org/users/local/5VyEEXyp/items/75GD3KBY"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/75GD3KBY"],"itemData":{"id":392,"type":"article-journal","title":"Community-based participatory development of a community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans","container-title":"Ethnicity & disease","page":"S1","volume":"21","issue":"3 0 1","author":[{"family":"Wennerstrom","given":"Ashley"},{"family":"Vannoy","given":"Steven D."},{"family":"Allen","given":"Charles E."},{"family":"Meyers","given":"Diana"},{"family":"O'Toole","given":"Elizabeth"},{"family":"Wells","given":"Kenneth B."},{"family":"Springgate","given":"Benjamin F."}],"issued":{"date-parts":[["2011"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Wennerstrom et al., 2011). Thus, this study aims to understand the role played by community health workers in the development of healthcare in post-Katrina New Orleans and assess customer satisfaction regarding the care they are being provided.

Research Objective

The primary objective of this research is to access the knowledge held by and the perception of healthcare consumers regarding the healthcare services provided by the community health workers in their community. It seeks to understand the ways in which hospitals can integrate community health workers into their system and see how beneficial this integration be, especially given their unique relationship with the community they serve. For the purpose of this study, the focus will be on the assessment of knowledge, practice, and satisfaction of health care services rendered by community health workers among health care consumers in New Orleans, Louisiana.

Significance of Research

Community healthcare workers serve as the frontline public health worker that is an integrated part of the said community and has a deep and personal understanding of the community it serves. They are not physician extenders, however, they can certainly serve as an intermediary body that can listen to your issues and refer your case to the right specialists, so that you may get the care that you need.

Thus, the significance of this research lies in its objective which is to see how useful community health workers have proven to be by enabling the communities to implement measures that have the potential to improve their well-being and reduce the need for hospital visits. Furthermore, their presence can smooth-line the entire process, making it easier for poverty-stricken communities as well as the minority groups to seek the help that they need.

Additionally, this study can also serve as a tool for assessment of how well the present healthcare provisions put in place in the state of Louisiana are doing. It will record how the healthcare is still at work providing relief to those affected by Hurricane Katrina years ago, especially with regard to community health workers and the communities that they work for ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fjRTzst7","properties":{"formattedCitation":"(Wennerstrom et al., 2011)","plainCitation":"(Wennerstrom et al., 2011)","noteIndex":0},"citationItems":[{"id":392,"uris":["http://zotero.org/users/local/5VyEEXyp/items/75GD3KBY"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/75GD3KBY"],"itemData":{"id":392,"type":"article-journal","title":"Community-based participatory development of a community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans","container-title":"Ethnicity & disease","page":"S1","volume":"21","issue":"3 0 1","author":[{"family":"Wennerstrom","given":"Ashley"},{"family":"Vannoy","given":"Steven D."},{"family":"Allen","given":"Charles E."},{"family":"Meyers","given":"Diana"},{"family":"O'Toole","given":"Elizabeth"},{"family":"Wells","given":"Kenneth B."},{"family":"Springgate","given":"Benjamin F."}],"issued":{"date-parts":[["2011"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Wennerstrom et al., 2011).

Literature Review

Community health workers have a unique position. They not only worked with their communities in an integrated manner, but they also improve the health care system by adding to the provided care. According to research ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"u1WwFKVL","properties":{"formattedCitation":"(Kok et al., 2017)","plainCitation":"(Kok et al., 2017)","noteIndex":0},"citationItems":[{"id":394,"uris":["http://zotero.org/users/local/5VyEEXyp/items/6LZ9E3YQ"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/6LZ9E3YQ"],"itemData":{"id":394,"type":"article-journal","title":"Optimising the benefits of community health workers’ unique position between communities and the health sector: a comparative analysis of factors shaping relationships in four countries","container-title":"Global public health","page":"1404-1432","volume":"12","issue":"11","author":[{"family":"Kok","given":"Maryse C."},{"family":"Ormel","given":"Hermen"},{"family":"Broerse","given":"Jacqueline EW"},{"family":"Kane","given":"Sumit"},{"family":"Namakhoma","given":"Ireen"},{"family":"Otiso","given":"Lilian"},{"family":"Sidat","given":"Moshin"},{"family":"Kea","given":"Aschenaki Z."},{"family":"Taegtmeyer","given":"Miriam"},{"family":"Theobald","given":"Sally"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Kok et al., 2017), community health workers are rather optimally placed to benefit the community and its health sector by shaping factors that enhance client satisfaction. The measures they employ not only improve the quality of life for community members but also reduces the frequency of hospital visits.

Earlier, it was believed that community health workers can only be highly effective in low- and middle-income countries ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"5xee0g38","properties":{"formattedCitation":"(Javanparast et al., 2018)","plainCitation":"(Javanparast et al., 2018)","noteIndex":0},"citationItems":[{"id":"nT7X3s8k/SkeabcR3","uris":["http://zotero.org/users/local/0omESN17/items/8M5RMD6X"],"uri":["http://zotero.org/users/local/0omESN17/items/8M5RMD6X"],"itemData":{"id":"dFPRiDjQ/mgQrOCoM","type":"article-journal","title":"Community health worker programs to improve healthcare access and equity: Are they only relevant to low-and middle-income countries?","container-title":"International journal of health policy and management","page":"943","volume":"7","issue":"10","author":[{"family":"Javanparast","given":"Sara"},{"family":"Windle","given":"Alice"},{"family":"Freeman","given":"Toby"},{"family":"Baum","given":"Fran"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Javanparast et al., 2018). However, the measures employed by a community health worker in an urban high-income situation, it has the potential to be just as valuable and useful. Household satisfaction was seen as an important indicator for measuring the quality of the care provided by a healthcare system. In various countries, such as Brazil, primary health care serves at household levels are provided using community health workers ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"pTItkqoS","properties":{"formattedCitation":"(Masango Makgobela, Ndimande, Ogunbanjo, Bongongo, & Nyalunga, 2019)","plainCitation":"(Masango Makgobela, Ndimande, Ogunbanjo, Bongongo, & Nyalunga, 2019)","noteIndex":0},"citationItems":[{"id":396,"uris":["http://zotero.org/users/local/5VyEEXyp/items/AZWXYASG"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/AZWXYASG"],"itemData":{"id":396,"type":"article-journal","title":"Households’ satisfaction with the healthcare services rendered by a ward-based outreach team in Tshwane district, Pretoria, South Africa","container-title":"South African Family Practice","page":"75-78","volume":"61","issue":"3","author":[{"family":"Masango Makgobela","given":"A. T."},{"family":"Ndimande","given":"J. V."},{"family":"Ogunbanjo","given":"G."},{"family":"Bongongo","given":"T."},{"family":"Nyalunga","given":"S. N."}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Masango Makgobela, Ndimande, Ogunbanjo, Bongongo, & Nyalunga, 2019). This has led to an improvement in their healthcare system and enables them to provide care to households in a better manner.

CHW roles and responsibilities are often outlined in government or NGO protocols for a CHW program or in documents that summarize the features of CHW programs across multiple countries ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"12aez28a","properties":{"formattedCitation":"(George et al., 2012; Kayemba et al., 2012)","plainCitation":"(George et al., 2012; Kayemba et al., 2012)","noteIndex":0},"citationItems":[{"id":451,"uris":["http://zotero.org/users/local/5VyEEXyp/items/9BPFV96A"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/9BPFV96A"],"itemData":{"id":451,"type":"article-journal","title":"Community health workers providing government community case management for child survival in sub-Saharan Africa: who are they and what are they expected to do?","container-title":"The American journal of tropical medicine and hygiene","page":"85-91","volume":"87","issue":"5_Suppl","author":[{"family":"George","given":"Asha"},{"family":"Young","given":"Mark"},{"family":"Nefdt","given":"Rory"},{"family":"Basu","given":"Roshni"},{"family":"Sylla","given":"Mariame"},{"family":"Clarysse","given":"Guy"},{"family":"Bannicq","given":"Marika Yip"},{"family":"De Sousa","given":"Alexandra"},{"family":"Binkin","given":"Nancy"},{"family":"Diaz","given":"Theresa"}],"issued":{"date-parts":[["2012"]]}}},{"id":452,"uris":["http://zotero.org/users/local/5VyEEXyp/items/CTG9VGUW"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/CTG9VGUW"],"itemData":{"id":452,"type":"article-journal","title":"Introduction of newborn care within integrated community case management in Uganda","container-title":"The American journal of tropical medicine and hygiene","page":"46-53","volume":"87","issue":"5_Suppl","author":[{"family":"Kayemba","given":"Christine Nalwadda"},{"family":"Sengendo","given":"Hanifah Naamala"},{"family":"Ssekitooleko","given":"James"},{"family":"Kerber","given":"Kate"},{"family":"Källander","given":"Karin"},{"family":"Waiswa","given":"Peter"},{"family":"Aliganyira","given":"Patrick"},{"family":"Guenther","given":"Tanya"},{"family":"Gamache","given":"Nathalie"},{"family":"Strachan","given":"Clare"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (George et al., 2012; Kayemba et al., 2012). The role of the CHW includes (but not limited to) identifying the sick child, assessing danger signs, treating the child with the correct drugs, arranging follow-up visits, completing patient registers, maintaining medicine stock records, and storing medicines correctly ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"zTz8JPKw","properties":{"formattedCitation":"(George et al., 2012)","plainCitation":"(George et al., 2012)","noteIndex":0},"citationItems":[{"id":451,"uris":["http://zotero.org/users/local/5VyEEXyp/items/9BPFV96A"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/9BPFV96A"],"itemData":{"id":451,"type":"article-journal","title":"Community health workers providing government community case management for child survival in sub-Saharan Africa: who are they and what are they expected to do?","container-title":"The American journal of tropical medicine and hygiene","page":"85-91","volume":"87","issue":"5_Suppl","author":[{"family":"George","given":"Asha"},{"family":"Young","given":"Mark"},{"family":"Nefdt","given":"Rory"},{"family":"Basu","given":"Roshni"},{"family":"Sylla","given":"Mariame"},{"family":"Clarysse","given":"Guy"},{"family":"Bannicq","given":"Marika Yip"},{"family":"De Sousa","given":"Alexandra"},{"family":"Binkin","given":"Nancy"},{"family":"Diaz","given":"Theresa"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (George et al., 2012).

CHW’s responsibilities into four domains of performance: building community relationships, providing care, managing commodities, and reporting. The domain of building community relationships concerns the relationships a CHW has with the people in his or her community; building awareness and confidence among community members and cultivating a sense of trust and approachability so that community members are willing to utilize the CHW’s services. Managing commodities concerns a CHW’s ability to keep and maintain the supplies and equipment necessary for their role, such as behavior change print materials, drugs and diagnostic tests, and scales or measurement devices. A CHW’s ability to manage a stock of drugs will depend on supply chain functioning, but CHWs may also play their own role in restocking drug kits. Providing care concerns the provision of care itself; for example, assessing, classifying, and treating sick children, and counseling caregivers. Some CHW programs, such as health promotion programs, do not require the delivery of clinical services, but nonetheless require CHWs to provide technical counseling and advice, or assessment and referral. Reporting concerns the paperwork that a CHW undertakes to document his or her activities, such as sick child forms, referral forms, patient registers, and monthly reports. Reporting is different to the other domains in that it does not directly contribute to the delivery of services, though arguably reporting does contribute to program effectiveness by providing policy makers and program managers with data to make more informed implementation decisions.

Articulating performance in this way helps to distinguish between CHW performance, and the performance of a CHW program as a whole, given other health system, community, and contextual factors. Whereas a program-centered term such as “quality of care” relies on both CHW performance in delivering care, and health system performance in making drugs available for the CHW to prescribe, the term “providing care” in the framework refers only to those actions within the control of a CHW, such as the correct assessment and treatment of sick children.

Uganda, according to some studies, has the highest percentages of child mortality globally. This high rate of child mortality has been attributed to the reduced presence of care and need for improving access to care. Community health workers are more than capable of reducing this epidemic, especially in rural areas by providing people with access to better care. They have been successfully able to do so by educating people on the matters of self-care, preventive measures, and a good diet to ensure that mothers are taking good care of themselves. This has not only improved child mortality rates but also has changed people’s outlook on the healthcare system ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"RE6czGGP","properties":{"formattedCitation":"(Wanduru et al., 2016)","plainCitation":"(Wanduru et al., 2016)","noteIndex":0},"citationItems":[{"id":397,"uris":["http://zotero.org/users/local/5VyEEXyp/items/XIXG756B"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/XIXG756B"],"itemData":{"id":397,"type":"article-journal","title":"The performance of community health workers in the management of multiple childhood infectious diseases in Lira, northern Uganda–a mixed methods cross-sectional study","container-title":"Global health action","page":"33194","volume":"9","issue":"1","author":[{"family":"Wanduru","given":"Phillip"},{"family":"Tetui","given":"Moses"},{"family":"Tuhebwe","given":"Doreen"},{"family":"Ediau","given":"Michael"},{"family":"Okuga","given":"Monica"},{"family":"Nalwadda","given":"Christine"},{"family":"Ekirapa-Kiracho","given":"Elizabeth"},{"family":"Waiswa","given":"Peter"},{"family":"Rutebemberwa","given":"Elizeus"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Wanduru et al., 2016).

Furthermore, Denver health study has shown that the integration of community health workers in healthcare programs have saved $2.28 for every $1 invested. Similar results were obtained by MHP Salud’s Community health worker-led cancer prevention program, which had a return in investment of about $3.16 on every dollar that was spent CITATION HPS79 \l 1033 (Salud, 2019). Integration of community health workers has also proven rather beneficial for a Baltimore Health Program CITATION CDC161 \l 1033 (CDC, 2016). It showed a 38% drop in emergency room visits and 30% drop in hospitalizations, leading to a reduction in Medicaid costs of 27% ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"eA14b6L6","properties":{"formattedCitation":"(Kumar, Mawson, Lavigine, & Dove, 2018)","plainCitation":"(Kumar, Mawson, Lavigine, & Dove, 2018)","noteIndex":0},"citationItems":[{"id":393,"uris":["http://zotero.org/users/local/5VyEEXyp/items/EWJ4D4YR"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/EWJ4D4YR"],"itemData":{"id":393,"type":"article-journal","title":"Effectiveness of Community Health Workers in Healthcare Delivery: Evidence from the Field","container-title":"Journal of Health Disparities Research and Practice","page":"5","volume":"11","issue":"2","author":[{"family":"Kumar","given":"Mukesh"},{"family":"Mawson","given":"Anthony"},{"family":"Lavigine","given":"Donna Antoine"},{"family":"Dove","given":"Cassandra"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Kumar, Mawson, Lavigine, & Dove, 2018). Since they know the culture, the language and particular challenges faced by the community they serve, community health workers are uniquely suited to build bridges between patients and healthcare professionals.

One such intermediate measure is CHW performance. The performance of CHWs is sometimes described in terms of quality of care or utilization ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"82tEpjRl","properties":{"formattedCitation":"(Cardemil, 2012; Miller et al., 2014)","plainCitation":"(Cardemil, 2012; Miller et al., 2014)","noteIndex":0},"citationItems":[{"id":454,"uris":["http://zotero.org/users/local/5VyEEXyp/items/JPZW94E6"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/JPZW94E6"],"itemData":{"id":454,"type":"article-journal","title":"Aspectos éticos en el tamizaje de hipoacusia neonatal en Chile","container-title":"Revista de otorrinolaringología y cirugía de cabeza y cuello","page":"249-260","volume":"72","issue":"3","author":[{"family":"Cardemil","given":"Felipe"}],"issued":{"date-parts":[["2012"]]}}},{"id":455,"uris":["http://zotero.org/users/local/5VyEEXyp/items/FZW2UX95"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/FZW2UX95"],"itemData":{"id":455,"type":"article-journal","title":"Integrated community case management of childhood illness in Ethiopia: implementation strength and quality of care","container-title":"The American journal of tropical medicine and hygiene","page":"424-434","volume":"91","issue":"2","author":[{"family":"Miller","given":"Nathan P."},{"family":"Amouzou","given":"Agbessi"},{"family":"Tafesse","given":"Mengistu"},{"family":"Hazel","given":"Elizabeth"},{"family":"Legesse","given":"Hailemariam"},{"family":"Degefie","given":"Tedbabe"},{"family":"Victora","given":"Cesar G."},{"family":"Black","given":"Robert E."},{"family":"Bryce","given":"Jennifer"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Cardemil, 2012; Miller et al., 2014). These measures are important as population-level indicators of program performance. To improve quality of care and utilization, we need to consider the physical and cognitive tasks that CHWs are asked to undertake. For ministries of health, understanding which tasks CHWs have been asked to perform, and how well they are performing at these tasks, can clarify program expectations, help to identify gaps in health system support, and inform performance improvement strategies. At the health-facility level, performance metrics can help supervisors of CHWs to identify strong or weak competencies in individual CHWs and set appropriate benchmarks.

Recent evaluation efforts have shown that many large-scale CHW programs are not impacting health outcomes as expected - not because the underlying CHW strategy is necessarily flawed, but because program implementation has been insufficiently strong to achieve success ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"OAFmwRDs","properties":{"formattedCitation":"(Amouzou, Kozuki, & Gwatkin, 2014; Bagonza, Kibira, & Rutebemberwa, 2014; Hermann et al., 2009; Miller et al., 2014)","plainCitation":"(Amouzou, Kozuki, & Gwatkin, 2014; Bagonza, Kibira, & Rutebemberwa, 2014; Hermann et al., 2009; Miller et al., 2014)","noteIndex":0},"citationItems":[{"id":457,"uris":["http://zotero.org/users/local/5VyEEXyp/items/ECQDXWBG"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/ECQDXWBG"],"itemData":{"id":457,"type":"article-journal","title":"Where is the gap?: the contribution of disparities within developing countries to global inequalities in under-five mortality","container-title":"BMC Public Health","page":"216","volume":"14","issue":"1","author":[{"family":"Amouzou","given":"Agbessi"},{"family":"Kozuki","given":"Naoko"},{"family":"Gwatkin","given":"Davidson R."}],"issued":{"date-parts":[["2014"]]}}},{"id":458,"uris":["http://zotero.org/users/local/5VyEEXyp/items/35A4XDR2"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/35A4XDR2"],"itemData":{"id":458,"type":"article-journal","title":"Performance of community health workers managing malaria, pneumonia and diarrhoea under the community case management programme in central Uganda: a cross sectional study","container-title":"Malaria journal","page":"367","volume":"13","issue":"1","author":[{"family":"Bagonza","given":"James"},{"family":"Kibira","given":"Simon PS"},{"family":"Rutebemberwa","given":"Elizeus"}],"issued":{"date-parts":[["2014"]]}}},{"id":456,"uris":["http://zotero.org/users/local/5VyEEXyp/items/YHWV45Q9"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/YHWV45Q9"],"itemData":{"id":456,"type":"article-journal","title":"Community health workers for ART in sub-Saharan Africa: learning from experience–capitalizing on new opportunities","container-title":"Human resources for health","page":"31","volume":"7","issue":"1","author":[{"family":"Hermann","given":"Katharina"},{"family":"Van Damme","given":"Wim"},{"family":"Pariyo","given":"George W."},{"family":"Schouten","given":"Erik"},{"family":"Assefa","given":"Yibeltal"},{"family":"Cirera","given":"Anna"},{"family":"Massavon","given":"William"}],"issued":{"date-parts":[["2009"]]}}},{"id":455,"uris":["http://zotero.org/users/local/5VyEEXyp/items/FZW2UX95"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/FZW2UX95"],"itemData":{"id":455,"type":"article-journal","title":"Integrated community case management of childhood illness in Ethiopia: implementation strength and quality of care","container-title":"The American journal of tropical medicine and hygiene","page":"424-434","volume":"91","issue":"2","author":[{"family":"Miller","given":"Nathan P."},{"family":"Amouzou","given":"Agbessi"},{"family":"Tafesse","given":"Mengistu"},{"family":"Hazel","given":"Elizabeth"},{"family":"Legesse","given":"Hailemariam"},{"family":"Degefie","given":"Tedbabe"},{"family":"Victora","given":"Cesar G."},{"family":"Black","given":"Robert E."},{"family":"Bryce","given":"Jennifer"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Amouzou, Kozuki, & Gwatkin, 2014; Bagonza, Kibira, & Rutebemberwa, 2014; Hermann et al., 2009; Miller et al., 2014). For this reason, program managers and evaluators are beginning to pay increasing attention to intermediate measures of program performance ( ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"wrgKPRJo","properties":{"formattedCitation":"(Callaghan-Koru et al., 2013)","plainCitation":"(Callaghan-Koru et al., 2013)","noteIndex":0},"citationItems":[{"id":459,"uris":["http://zotero.org/users/local/5VyEEXyp/items/B2WGDNKW"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/B2WGDNKW"],"itemData":{"id":459,"type":"article-journal","title":"Health systems supports for community case management of childhood illness: lessons from an assessment of early implementation in Malawi","container-title":"BMC Health Services Research","page":"55","volume":"13","issue":"1","author":[{"family":"Callaghan-Koru","given":"Jennifer A."},{"family":"Gilroy","given":"Kate"},{"family":"Hyder","given":"Adnan A."},{"family":"George","given":"Asha"},{"family":"Nsona","given":"Humphreys"},{"family":"Mtimuni","given":"Angella"},{"family":"Zakeyo","given":"Bernie"},{"family":"Mayani","given":"Josiah"},{"family":"Cardemil","given":"Cristina V."},{"family":"Bryce","given":"Jennifer"}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} Callaghan-Koru et al., 2013; UNICEF, 2014). Evaluators need data on program processes and outputs to identify barriers to implementation and develop strategies to overcome these barriers, and program managers need similar data to inform real-time decision making and resource allocation ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"oB1GP8SH","properties":{"formattedCitation":"(Hazel, Guenther, Marsh, Swedberg, & Bryce, 2014; Mitsunaga et al., 2013)","plainCitation":"(Hazel, Guenther, Marsh, Swedberg, & Bryce, 2014; Mitsunaga et al., 2013)","noteIndex":0},"citationItems":[{"id":461,"uris":["http://zotero.org/users/local/5VyEEXyp/items/IHGCERRQ"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/IHGCERRQ"],"itemData":{"id":461,"type":"article-journal","title":"Translating Research into Action (TRAction) Implementation Research Embedded in Integrated Community Case Management (CCM) Program: Final Technical Report","container-title":"Washington, DC","author":[{"family":"Hazel","given":"E."},{"family":"Guenther","given":"T."},{"family":"Marsh","given":"D."},{"family":"Swedberg","given":"E."},{"family":"Bryce","given":"J."}],"issued":{"date-parts":[["2014"]]}}},{"id":460,"uris":["http://zotero.org/users/local/5VyEEXyp/items/8CE5QSS6"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/8CE5QSS6"],"itemData":{"id":460,"type":"article-journal","title":"Utilizing community health worker data for program management and evaluation: systems for data quality assessments and baseline results from Rwanda","container-title":"Social science & medicine","page":"87-92","volume":"85","author":[{"family":"Mitsunaga","given":"Tisha"},{"family":"Hedt-Gauthier","given":"Bethany"},{"family":"Ngizwenayo","given":"Elias"},{"family":"Farmer","given":"Didi Bertrand"},{"family":"Karamaga","given":"Adolphe"},{"family":"Drobac","given":"Peter"},{"family":"Basinga","given":"Paulin"},{"family":"Hirschhorn","given":"Lisa"},{"family":"Ngabo","given":"Fidele"},{"family":"Mugeni","given":"Cathy"}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hazel, Guenther, Marsh, Swedberg, & Bryce, 2014; Mitsunaga et al., 2013).

Research Methodology

Study Area

New Orleans is a consolidated city-parish in Louisiana. The landmass has an area dimension of 349.85 sq. mi. i.e. 906.10 km squared. It is located alongside the Mississippi River and considered to be a major port city in the country. New Orleans was one of the most severely affected areas as a result of Hurricane Katrina on 29th of August 2005. The event flooded more than 80% of the city and caused the death and displacement of thousands of people around the city. Community health workers were a huge help to the population stuck in the area in response to the epidemic.

Study Population

An approximate total population of New Orleans, Louisiana is 391,006 people as of 2018, which makes it the most populous city in the region ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"yExwY2Fn","properties":{"formattedCitation":"(U. S. CensusBureau, 2018)","plainCitation":"(U. S. CensusBureau, 2018)","noteIndex":0},"citationItems":[{"id":449,"uris":["http://zotero.org/users/local/5VyEEXyp/items/YWVVBWV7"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/YWVVBWV7"],"itemData":{"id":449,"type":"webpage","title":"American FactFinder - Community Facts","abstract":"American FactFinder is your source for population, housing, economic and geographic information., American FactFinder is your source for population, housing, economic and geographic information.","URL":"https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml","language":"en","author":[{"family":"U. S. CensusBureau","given":""}],"issued":{"date-parts":[["2018"]]},"accessed":{"date-parts":[["2019",8,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (U. S. Census Bureau, 2018). The city is well known for its unique cross-cultural and multilingual society. Hurricane Katrina displaced more than 800,000 people, however, between 2010 and 2015, the city drew by 12% on an annual basis, which means an addition of 10,000 to the city’s population annually. This increase in population will also be a part of the study in order to understand and access the community’s response to community health workers in the area.

Study Duration

For the purpose of the study, the sample population comprised of individuals that were already in the city when it was affected by Hurricane Katrina. Those individuals that moved into the city a long time after Hurricane Katrina were also enrolled in the study for comparative analysis. The study duration will be from 2006, when Katrina actually hit, to 2018 i.e. 12 years from when the disaster first struck.

Sampling Method

The study designed for the purpose of the research was a cross-sectional survey. Data collection in this study was carried through a mix of quantitative (client exit interviews) as well as qualitative methods, which includes the discussion of the focus groups. There will be four primary focus groups. The first group will include individuals that were in the city when Katrina struck and didn’t relocate following the hurricane. The second group will include people that relocated as a result of hurricane Katrina, but later returned to the city after its rehabilitation. The third group included individuals that moved into the city post-Katrina. The fourth group will comprise of individuals that belong to a well-developed city, with an extensive and successful network of healthcare, such as Florida or California. Given the income of tourists in the area for Mardi Gras, it would be easy enough to find and interview the required population. The purpose of group two and four will be put into place for comparative purposes, which will enable the assessment of group one and three.

Sample Size

The sample size for client exit interviews was determined by talking to various patients coming to see a community health worker, as well as the doctors involved in situations where community health worker plays the role of a mediator. The anticipated response rate for this study was 90%, with an adjustment being made to cover for non-response rate. The sample was divided using a factor f, which was estimated as the response rate by dividing the total population with the 0.9 for 90%. Apart from the interview, questionnaires were also distributed among the sample population. It was made sure that all the samples being distributed were filled and later analyzed.

Study Tools

For the purpose of research, a pretested standardized semi-structured questionnaire was used to obtain information on the socio-demographic characteristics of the client. This also yields the knowledge of the client on the basis of equality of care, along with the delivery of care as well as its frequency among the masses in terms of prompt attention, customer’s level of satisfaction and the quality of care being delivered. This will yield the data needed for quantitative analysis on the basis of close ended questions in the responses. Furthermore, they will also be interview of one of one basis to get a better understanding of their history as well as their experience as a result of hurricane Katrina. The open-ended questions in the questionnaires and the interview will serve as the basic material needed for qualitative assessment of the obtained responses.

Data Analysis

Quantitative data was then analyzed using XL Stat and frequency distributions of all relevant variables were presented in tables. The calculated means, along with standard deviations were determined, with statistical significance analyzed using correlation matrix. On the other hand, the qualitative means of assessment were subjected to intense scrutiny and then subjected to thematic and comparative analysis of the responses based on the groups the people had been divided into.

Observations and Findings

The observations and findings collected as a result of review of literature have relayed some fact, which reflect the various ways the healthcare system may be improved in New Orleans, and the entire state of Louisiana as a whole. The review of literature on the subject explain how devastated Post-Katrina New Orleans was, especially in terms of healthcare and the need for it in the city. However, the situation was already deplorable to begin with. According to the Census held in 2000, Louisiana is the poorest of all US states. When Katrina devastated the New Orleans healthcare safety net, it completely changed the healthcare landscape of the city. It left many without access to healthcare for over a year, with local officials struggling to rebuild the city (Rudowitz et al., 2006). However, it wasn't doing all that well in terms of healthcare Pre-katrina as well. The state of Louisiana in terms of healthcare network available to the masses (Morial, 2007). Community health workers were a huge support in dealing with Post-Katrina New Orleans. Not only did the help the healthcare providers with the patients, but they also allowed the healthcare system to vastly improve in short among of time.

Discussion and Conclusion

The data obtained on the subject shows certain limitations with regard to the services offered by community health worker services, especially in a city like New Orleans. Thus, this study was based on the views of the service provides, the customers seeking healthcare and the community health workers themselves. However, it limits the understanding of the study’s weaknesses, especially given the involvement of the user’s perspectives. Additionally, the policies in place that dictate the sort of services that should be provided overlooks the needs of poor households and what they need in terms of these services. A wide range of successful models would have provided a better understanding on the subject than the one that is available at present. Another limitation was the choice of city. Choosing a more urban city would have yielded more data and a better set of results, however, it would not have made for an excellent study or given me something to compare the materials up against.

Despite the limitations, the methodology adopted in the study would enable an in-depth understanding of the experiences of a community health worker in the efforts to ensure that the communities they are working with not only have access to a wide range of services, but the basic services that they definitely needed as well. It also gives a change to look into the methods employed by community health workers to reach out to poor communities. This allows the study to dissect the finer components of the issue at hand and potentially contribute to the ability of a community health worker to negotiate the circumstances faced by poor households.

It motivates that to strengthen of the capacity of community health workers in the health system, it is crucial for those in authority to prioritize their training, their supervision and the level of institutional support provided. The study further asserts that poor communities, where CHWs often have to provide their services, need other multifaceted development services which will enable CHWs to provide more effective services to improve the health and wellbeing of marginalized communities. Furthermore, the study indicates that while inter-sectoral action is regarded as a macro level function, providing services that work across sectors while facilitating inter-sectoral action through outreach services at the community level.

The study is aimed to examine the extend of community health worker’s contribution to the rehabilitation of New Orleans by participating in various community events and working with factors that enable the provision of such outreach services. It is supposed to analyze the given literature in supplementary perspective and add to the known facts in a superlative manner.

Salient Recommendations

Given the already available material on the benefits of using community health workers to collaborate with basic healthcare services has shown that how crucial it is to absorb the community health workers into the health system. This will show the sector’s capacity to not only sufficiently support these workers, but also enables the society to build effective and personal network of healthcare. It will also exhibit a more effective use of finances and the resources being put into the healthcare system by saving a physician’s time and leading healthcare workers to exactly where they need to be at the time. Furthermore, this study emphasises the importance of institutional relationships, including the nature of such relationships in implementing community-based interventions in poor communities. While my study acknowledges the role of the health sector in motivating and guiding other sectors to appreciate the importance of inter-sectoral action, it highlights the greater need for a state-wide’ approach of central government.


The community health workers serve as a bridge between primary healthcare providers and healthcare consumer (Javanparast, Windle, Freeman, & Baum, 2018). In this instance, the primary healthcare providers are the doctors and the nurses that tend to your issues at a primary care facility, with the patients and their families serving as the healthcare consumer (Javanparast et al., 2018). Community health workers offer insight, along with services that address the scope of the health care model. The activities undertaken by community health workers include a wide variety of areas that require attention.It ushered in a storm of such magnitude that the state of Louisiana and its healthcare system has yet to recover from its devastating effects (Mammoser, 2017). This system was reformed by community health workers, giving healthcare to those caught in the middle of unprecedented devastation and urgent need of healthcare. They worked alongside first responders and helped wherever they can, in just about every possibility that they possibly could (Wennerstrom et al., 2011). This study aimed to understand the extend of community health worker’s contribution to the rehabilitation of New Orleans by participating in various community events and working with factors that enable the provision of such outreach services. By using both qualitative and quantitative analysis of the data obtained, the issue with the understood and addressed on a grander scale in hopes to understand the assessment of knowledge, practice, and satisfaction of health care services rendered by community health workers among health care consumers.


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Miller, N. P., Amouzou, A., Tafesse, M., Hazel, E., Legesse, H., Degefie, T., … Bryce, J. (2014). Integrated community case management of childhood illness in Ethiopia: Implementation strength and quality of care. The American Journal of Tropical Medicine and Hygiene, 91(2), 424–434.

Mitsunaga, T., Hedt-Gauthier, B., Ngizwenayo, E., Farmer, D. B., Karamaga, A., Drobac, P., … Mugeni, C. (2013). Utilizing community health worker data for program management and evaluation: Systems for data quality assessments and baseline results from Rwanda. Social Science & Medicine, 85, 87–92.

Mohajer, N., & Singh, D. (2018). Factors enabling community health workers and volunteers to overcome socio-cultural barriers to behaviour change: Meta-synthesis using the concept of social capital. Human Resources for Health, 16(1), 63.

Morial, J. C. (2007). Katrina: Health Care System Recovery, Reform, and Renaissance. The Permanente Journal, 11(4), 66.

Osae-Larbi, J. A. (2016). Bridging the language barrier gap in the health of multicultural societies: Report of a proposed mobile phone-based intervention using Ghana as an example. Springer.

Rudowitz, R., Rowland, D., & Shartzer, A. (2006). Health Care In New Orleans Before And After Hurricane Katrina: The storm of 2005 exposed problems that had existed for years and made solutions more complex and difficult to obtain. Health Affairs, 25(Suppl1), W393–W406.

U. S. CensusBureau. (2018). American FactFinder—Community Facts. Retrieved August 5, 2019, from https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml

Wanduru, P., Tetui, M., Tuhebwe, D., Ediau, M., Okuga, M., Nalwadda, C., … Rutebemberwa, E. (2016). The performance of community health workers in the management of multiple childhood infectious diseases in Lira, northern Uganda–a mixed methods cross-sectional study. Global Health Action, 9(1), 33194.

Wennerstrom, A., Vannoy, S. D., Allen, C. E., Meyers, D., O’Toole, E., Wells, K. B., & Springgate, B. F. (2011). Community-based participatory development of a community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans. Ethnicity & Disease, 21(3 0 1), S1.

Subject: Healthcare and Nursing

Pages: 20 Words: 6000

Assessment Part 2 ‘ Intergrated Literature Review


[Institutional Affiliation(s)]

Author Note

Is Euthanasia Everyone's, Right?

Literature Review

End of life decision or Euthanasia is also called mercy killing or an act of intentionally painless ending life to relief from the suffering and pain, due to an incurable disease or debilitating physical disorder. Euthanasia is also defined as “an act of painlessly putting a person suffering from painful and deadly disease or debilitating physical disorder, into death or withdrawing from artificial life-support measures”. Literature suggests that there are two types of euthanasia, i.e. active and passive euthanasia. In active euthanasia, doctors perform some action to bring an end to the patient's life. While in passive euthanasia, the patient chooses to die on his own, in the sense that the doctor is not practically involved in patients death. In both cases, the two questions arise, whether it is ethical for a patient himself or a doctor to put human life into death, and is euthanasia everyone's right? Even though the state is supposed to ensure the right to life to everyone, living in the society, it has no right to deny the people's wish to die given the traumatic circumstances ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ceJPij92","properties":{"formattedCitation":"(Keown and Keown 2002)","plainCitation":"(Keown and Keown 2002)","noteIndex":0},"citationItems":[{"id":330,"uris":["http://zotero.org/users/local/55bqtMd8/items/TLJADSIF"],"uri":["http://zotero.org/users/local/55bqtMd8/items/TLJADSIF"],"itemData":{"id":330,"type":"book","title":"Euthanasia, Ethics and Public Policy: An Argument Against Legalisation","publisher":"Cambridge University Press","number-of-pages":"342","source":"Google Books","abstract":"Whether the law should permit voluntary euthanasia or physician-assisted suicide is one of the most vital questions facing all modern societies. Internationally, the main obstacle to legalisation has proved to be the objection that, even if they were morally acceptable in certain 'hard cases', voluntary euthanasia and physician-assisted suicide could not be effectively controlled; society would slide down a 'slippery slope' to the killing of patients who did not make a free and informed request, or for whom palliative care would have offered an alternative. How cogent is this objection? This book provides the general reader (who need have no expertise in philosophy, law or medicine) with a lucid introduction to this central question in the debate, not least by reviewing the Dutch euthanasia experience. It will interest all in any country whether currently for or against legalisation, who wish to ensure that their opinions are better informed.","ISBN":"978-0-521-00933-1","note":"Google-Books-ID: ce83gBnSpfYC","title-short":"Euthanasia, Ethics and Public Policy","language":"en","author":[{"family":"Keown","given":"John"},{"family":"Keown","given":"Rose Kennedy Professor John"}],"issued":{"date-parts":[["2002",4,25]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Keown and Keown 2002).

From an ethical and moral point of view, euthanasia is also called death humanisation or “dignified death”. Considering euthanasia as a legitimate right to everyone will bring about a potential change in social attitudes towards illness, old age, physiological illness, disability and role of the medical profession in society ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"DqgFL7Ay","properties":{"formattedCitation":"(Erimia 2016)","plainCitation":"(Erimia 2016)","noteIndex":0},"citationItems":[{"id":332,"uris":["http://zotero.org/users/local/55bqtMd8/items/ZELZ9NMK"],"uri":["http://zotero.org/users/local/55bqtMd8/items/ZELZ9NMK"],"itemData":{"id":332,"type":"article-journal","title":"Ethical and Legislative Aspects on The Legalisation Of Euthanasia From The Patient Rights Perspective","container-title":"Jurnalul de Drept si Stiinte Administrative","page":"49-62","volume":"1","issue":"5","author":[{"family":"Erimia","given":"Cristina-Luiza"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Erimia 2016). Euthanasia is debated over a long period whether it is justified by the ‘individual's right to life’, and the right to make an ‘end of life decision’ with dignity. Many believe that allowing for euthanasia is as similar to allowing for suicide. Those who are suffering from terminal and acute illness think that choosing to die with dignity is somewhat better than being dependent on mock life support measures ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ye0JVbxo","properties":{"formattedCitation":"(Baksheev et al. 2018)","plainCitation":"(Baksheev et al. 2018)","noteIndex":0},"citationItems":[{"id":335,"uris":["http://zotero.org/users/local/55bqtMd8/items/ZPNPKUUD"],"uri":["http://zotero.org/users/local/55bqtMd8/items/ZPNPKUUD"],"itemData":{"id":335,"type":"article-journal","title":"Euthanasia in modern society: the topicality, practicability, and medical aspect of the problem","container-title":"Journal of pharmaceutical sciences and research","page":"1360-1363","volume":"10","issue":"6","author":[{"family":"Baksheev","given":"A. I."},{"family":"Turchina","given":"Zh E."},{"family":"Mineev","given":"V. V."},{"family":"Maksimov","given":"S. V."},{"family":"Rakhinsky","given":"D. V."},{"family":"Aisner","given":"L. Yu"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Baksheev et al. 2018)

Many religious groups believe that terminal illness or disability is a divine opportunity for a human being to purify his soul. In the Christian worldview, choosing voluntary euthanasia is strictly prohibited. Christianity believes that life is given by God and human beings are God’s images, so they have no right to surrender their life to the death against the will of God ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"G4u3FQVr","properties":{"formattedCitation":"(Richmond 2014)","plainCitation":"(Richmond 2014)","noteIndex":0},"citationItems":[{"id":336,"uris":["http://zotero.org/users/local/55bqtMd8/items/6XUSZH94"],"uri":["http://zotero.org/users/local/55bqtMd8/items/6XUSZH94"],"itemData":{"id":336,"type":"article-journal","title":"How should Christians respond to proposals to legalise euthanasia and assisted suicide?","container-title":"Stimulus: The New Zealand Journal of Christian Thought and Practice","page":"20","volume":"21","issue":"1","author":[{"family":"Richmond","given":"David"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Richmond 2014). However, some other faith groups oppose this way of thinking. According to them, if the Bible says that God has better plans for all his humans, and he loves them a lot, how would he allow his followers to suffer from such a painful experience.

The libertarian argument on euthanasia suggests that death is everyone's mater if it is not harmful to others in society. No one including state and law-making bodies have the right to interfere in someone's decision of voluntary euthanasia. The utilitarian perspective on euthanasia suggests that if a person is no more able to work, it means that their utility has been ended, and he can no longer contribute to the happiness of the society. In this situation, the utility of active euthanasia lets the money to be invested in researching the cure instead of maintaining the life of a patient with acute and terminal illness ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"WK4aDEaG","properties":{"formattedCitation":"(Utilitarianism View on Euthanasia | Liberrimus n.d.)","plainCitation":"(Utilitarianism View on Euthanasia | Liberrimus n.d.)","noteIndex":0},"citationItems":[{"id":340,"uris":["http://zotero.org/users/local/55bqtMd8/items/N492ZPR4"],"uri":["http://zotero.org/users/local/55bqtMd8/items/N492ZPR4"],"itemData":{"id":340,"type":"webpage","title":"Utilitarianism View on Euthanasia | Liberrimus","URL":"https://sites.dwrl.utexas.edu/liberrimus/2016/10/04/utilitarianism-view-on-euthanasia/","accessed":{"date-parts":[["2019",10,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Utilitarianism View on Euthanasia | Liberrimus n.d.)

The patients with terminal illness or disability sometimes suffer from extreme pain and their life to be dependent on others. Such a situation forces them to take the possibility of voluntary euthanasia under consideration. They think that it is their right to choose death for themselves, without concerning that either it is active or passive, it is morally wrong ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"gSwuLEdS","properties":{"formattedCitation":"(Mokuolu 2017)","plainCitation":"(Mokuolu 2017)","noteIndex":0},"citationItems":[{"id":342,"uris":["http://zotero.org/users/local/55bqtMd8/items/F4GCBRWV"],"uri":["http://zotero.org/users/local/55bqtMd8/items/F4GCBRWV"],"itemData":{"id":342,"type":"article-journal","title":"End of Life Decisions: The extent to which quality of life factors should affect them","container-title":"Kent Student Law Review","volume":"3","author":[{"family":"Mokuolu","given":"Toluwani Ayobami"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mokuolu 2017). The problem is that not everyone can afford the pain management facility; this would lead the people to choose for death with dignity through active or passive euthanasia.

In support of active euthanasia, it is argued that if people have a legitimate right to live with dignity, their right to die with dignity should also be legitimised. Some situations are so painful and prolonged that it becomes impossible for medical professionals to assuage the sufferings through palliative care. In the modern view, the unprecedented prolongation of human life is the way of controlling death. Spending time and money on pointless sufferings is a pressure on the patient himself, his/her family and the healthcare system. So the argument is not cruel and mocking to help such patients in bringing their lives to death if they are repeatedly requesting ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VGU0RxnC","properties":{"formattedCitation":"(Right to die? | Brain | Oxford Academic n.d.)","plainCitation":"(Right to die? | Brain | Oxford Academic n.d.)","noteIndex":0},"citationItems":[{"id":346,"uris":["http://zotero.org/users/local/55bqtMd8/items/8XM43U7D"],"uri":["http://zotero.org/users/local/55bqtMd8/items/8XM43U7D"],"itemData":{"id":346,"type":"webpage","title":"Right to die? | Brain | Oxford Academic","URL":"https://academic.oup.com/brain/article/134/1/318/294871","accessed":{"date-parts":[["2019",10,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Right to die? | Brain | Oxford Academic n.d.).

The supportive argument in favour of physician-assisted euthanasia claims no one has any right and role to play in coming into life, but we do have the right to decide how long we remain in existence, especially in traumatic situations when someone keeps fighting with his/her life. However, the right to euthanasia does not mean that it is always a moral right to choose to die.

In opposition to the above argument, the American Medical Association reject the act of euthanasia, according to which "It is incompatible with the prohibition of using medical devices to cause the death to a patient". The Association prohibits the members from participating in voluntary active euthanasia by putting forward a slogan "physicians should not be executioners" ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4qR1pvJ5","properties":{"formattedCitation":"(Chekhovska et al. 2019)","plainCitation":"(Chekhovska et al. 2019)","noteIndex":0},"citationItems":[{"id":352,"uris":["http://zotero.org/users/local/55bqtMd8/items/9DJA9ZAZ"],"uri":["http://zotero.org/users/local/55bqtMd8/items/9DJA9ZAZ"],"itemData":{"id":352,"type":"article-journal","title":"EUTHANASIA OR PALLIATIVE CARE: LEGAL PRINCIPLES OF THE IMPLEMENTATION IN THE CONTEXT OF THE REALIZATION OF HUMAN RIGHTS TO LIFE","container-title":"Wiad Lek","page":"677-681","volume":"72","issue":"4","author":[{"family":"Chekhovska","given":"Iryna V."},{"family":"Balynska","given":"Olha M."},{"family":"Blahuta","given":"Roman I."},{"family":"Sereda","given":"Valeriy V."},{"family":"Mosondz","given":"Serhii O."}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chekhovska et al. 2019)

Advocates of principles of autonomy assert that everyone has the right to die or choose voluntary euthanasia, but there is no evidence in history for its legalisation. Literature has almost failed to answer the literal meaning of "right to die" and how anyone can decide; rather, it is a rationally defensible proposition. Also, there is no evidence of the link between euthanasia and suicide. Defining suicide clearly is necessary to accept euthanasia as a right of individuals ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"BUI00upf","properties":{"formattedCitation":"(Scolding 2010)","plainCitation":"(Scolding 2010)","noteIndex":0},"citationItems":[{"id":354,"uris":["http://zotero.org/users/local/55bqtMd8/items/Y3W2U4A9"],"uri":["http://zotero.org/users/local/55bqtMd8/items/Y3W2U4A9"],"itemData":{"id":354,"type":"article-journal","title":"Right to die?","container-title":"Brain","page":"318-321","volume":"134","issue":"1","author":[{"family":"Scolding","given":"Neil"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Scolding 2010).

Activist against voluntary euthanasia argues that legitimating voluntary euthanasia will prove to be a slippery slope towards increasing numbers of nonvoluntary euthanasia. In the countries where euthanasia is legal, there should be strict guidelines, and a necessary second opinion of the physiatrist should be taken as a standardized measure of legalization of euthanasia ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"QuPZhsz8","properties":{"formattedCitation":"(Annadurai, Danasekaran, and Mani 2014)","plainCitation":"(Annadurai, Danasekaran, and Mani 2014)","noteIndex":0},"citationItems":[{"id":355,"uris":["http://zotero.org/users/local/55bqtMd8/items/PJ56WB57"],"uri":["http://zotero.org/users/local/55bqtMd8/items/PJ56WB57"],"itemData":{"id":355,"type":"article-journal","title":"‘Euthanasia: Right to Die with Dignity’","container-title":"Journal of Family Medicine and Primary Care","page":"477-478","volume":"3","issue":"4","source":"PubMed Central","DOI":"10.4103/2249-4863.148161","ISSN":"2249-4863","note":"PMID: 25657977\nPMCID: PMC4311376","title-short":"‘Euthanasia","journalAbbreviation":"J Family Med Prim Care","author":[{"family":"Annadurai","given":"Kalaivani"},{"family":"Danasekaran","given":"Raja"},{"family":"Mani","given":"Geetha"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Annadurai, Danasekaran, and Mani 2014).

Moving towards the contemporary perspective on “Is euthanasia everyone’s right”, it is found that the Netherlands was the first country in which euthanasia is considered as a democratic right of individuals, with a strict condition; the patient is suffering agonising pain. Their illness must be chronic and terminal, and the demand for voluntary euthanasia made by the patient in full consciousness. According to the rules, patients whose life expectancy is two or less than two weeks are supposed to put in comma which is medically induced, along with the withdrawal of hydration and all kinds of nutrition ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jsl6a5el","properties":{"formattedCitation":"(staff 2014)","plainCitation":"(staff 2014)","noteIndex":0},"citationItems":[{"id":357,"uris":["http://zotero.org/users/local/55bqtMd8/items/DRDMKT4Q"],"uri":["http://zotero.org/users/local/55bqtMd8/items/DRDMKT4Q"],"itemData":{"id":357,"type":"article-newspaper","title":"Euthanasia and assisted suicide laws around the world","container-title":"The Guardian","section":"Society","source":"www.theguardian.com","abstract":"On Friday the House of Lords will debate a bill on assisted dying. See how other countries have legislated on the issue","URL":"https://www.theguardian.com/society/2014/jul/17/euthanasia-assisted-suicide-laws-world","ISSN":"0261-3077","language":"en-GB","author":[{"family":"staff","given":"Guardian"}],"issued":{"date-parts":[["2014",7,17]]},"accessed":{"date-parts":[["2019",10,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (staff 2014).

In the United States, doctors are allowed for lethal sedation to the patients with a terminal illness, in only five US states; however, the right to voluntary euthanasia is still not legalised by the state. There is a movement "aid in dying" against active euthanasia is gaining much attention, but the issue is still controversial. Around 300 patients with terminal illnesses are suggested for lethal medication; among them, 230 people died as a result of this step. Many other countries, including Belgium, Germany, France, and Switzerland, are also stepping ahead to legalise both active and passive euthanasia as an individual's autonomous right ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"462vL6Kt","properties":{"formattedCitation":"(staff 2014)","plainCitation":"(staff 2014)","noteIndex":0},"citationItems":[{"id":357,"uris":["http://zotero.org/users/local/55bqtMd8/items/DRDMKT4Q"],"uri":["http://zotero.org/users/local/55bqtMd8/items/DRDMKT4Q"],"itemData":{"id":357,"type":"article-newspaper","title":"Euthanasia and assisted suicide laws around the world","container-title":"The Guardian","section":"Society","source":"www.theguardian.com","abstract":"On Friday the House of Lords will debate a bill on assisted dying. See how other countries have legislated on the issue","URL":"https://www.theguardian.com/society/2014/jul/17/euthanasia-assisted-suicide-laws-world","ISSN":"0261-3077","language":"en-GB","author":[{"family":"staff","given":"Guardian"}],"issued":{"date-parts":[["2014",7,17]]},"accessed":{"date-parts":[["2019",10,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (staff 2014).

Modernised view of dealing with death suggests that, same as everyone has a right to life, he/she is autonomous to make his end of life decisions. So euthanasia is an individual's right to choose whether to live with the sufferings or die with dignity, instead of depending on other people and life support measures. This is because a person who is terminally ill, dependent on others and is no more a contributor to societal happiness is already virtually dead. The first and foremost reason why a person exists in this world is to socialize with others and enjoy life. One of the major issues with both active a passive euthanasia is whether it is beneficial for a person to be dead or remain alive. Legalizing any type of euthanasia conveys a powerful message of double standards of ranking human's life in terms of inviolability.Legalising euthanasia as everyone's right willresult in the legalisation of assisted suicide as a healthcare choice. At times it will result in a perceived or real pressure on the elderly, terminally ill, disabled, and other persons with acute illness to opt for euthanasia. It is just like someone else is taking the end of life decision for a patient without his/her consent.

The arguments in support and criticism on considering euthanasia as everyone's right, reflects the shift of focus towards the legalization of assisted suicide. The three conclusive reasons are relieving the sufferings from pain, respecting the autonomy of the patient and protecting the dignity. Whereas the arguments against euthanasia emerge from societal considerations of moral principles and ethics, apart from the sufferer. The societal principles always remain the same, but the democratization of euthanasia is more humane than to linger on the suffering of a patient with painful life-saving measures. However, people should be allowed to use these rights on reasonable groundsto make the decision legal and justified.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Annadurai, Kalaivani, Raja Danasekaran, and Geetha Mani. 2014. "'Euthanasia: Right to Die with Dignity.'" Journal of Family Medicine and Primary Care 3(4): 477–78.

Baksheev, A. I. et al. 2018. “Euthanasia in Modern Society: The Topicality, Practicability, and Medical Aspect of the Problem.” Journal of pharmaceutical sciences and research 10(6): 1360–63.


Erimia, Cristina-Luiza. 2016. "Ethical and Legislative Aspects of The Legalisation Of Euthanasia From The Patient Rights Perspective." Jurnalul de DreptsiStiinte Administrative 1(5): 49–62.

Keown, John, and Rose Kennedy Professor John Keown. 2002. Euthanasia, Ethics and Public Policy: An Argument Against Legalisation. Cambridge University Press.

Mokuolu, ToluwaniAyobami. 2017. “End of Life Decisions: The Extent to Which Quality of Life Factors Should Affect Them.” Kent Student Law Review 3.

Richmond, David. 2014. “How Should Christians Respond to Proposals to Legalise Euthanasia and Assisted Suicide?” Stimulus: The New Zealand Journal of Christian Thought and Practice 21(1): 20.

“Right to Die? | Brain | Oxford Academic.” https://academic.oup.com/brain/article/134/1/318/294871 (October 24, 2019).

Scolding, Neil. 2010. “Right to Die?” Brain 134(1): 318–21.

staff, Guardian. 2014. "Euthanasia and Assisted Suicide Laws Around the World." The Guardian. https://www.theguardian.com/society/2014/jul/17/euthanasia-assisted-suicide-laws-world (October 24, 2019).

“Utilitarianism View on Euthanasia | Liberrimus.” https://sites.dwrl.utexas.edu/liberrimus/2016/10/04/utilitarianism-view-on-euthanasia/ (October 24, 2019).

Subject: Healthcare and Nursing

Pages: 5 Words: 1500

Assessment Task 1 Becoming Culturally Aware

Becoming Culturally Aware

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Becoming Culturally Aware

Part One


Considerations- 2 answers each section

Styles of dress

Americans dress code in the hospitals is to wear operation theatre kit so that they get minimum infections

Chinese dress code is to wear a uniform and a face mask

Ways of greeting people

Americans are considered as racists and they differentiate people based on their culture ethnicity and religion ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"oSRnnuGs","properties":{"formattedCitation":"(Ajilore, 2019)","plainCitation":"(Ajilore, 2019)","noteIndex":0},"citationItems":[{"id":215,"uris":["http://zotero.org/users/local/smYQhi21/items/8I422DWF"],"uri":["http://zotero.org/users/local/smYQhi21/items/8I422DWF"],"itemData":{"id":215,"type":"webpage","title":"The Harvest of American Racism","container-title":"Center for American Progress","abstract":"Using the market mechanism to solve structural problems is the wrong approach to improving distressed communities.","URL":"https://www.americanprogress.org/issues/economy/news/2019/09/17/474567/harvest-american-racism/","language":"en-US","author":[{"family":"Ajilore","given":"Olugbenga"}],"issued":{"date-parts":[["2019",9,17]]},"accessed":{"date-parts":[["2019",11,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ajilore, 2019). However, they show some resilience in becoming friends.

Chinese people are known for their greeting behaviour and the very first thing while greeting someone is that they bow their heads

Beliefs about hospitality

America is now a diversified state having many people from all over the world they now welcome people.

Chinese are good at hospitality and they believe that welcoming someone with hospitability enhances the connections and their relationships

Importance of time

Americans are punctual and they are time conscious

Chinese are also punctual, and they prefer to deliver their work and services on time


Americans believe in a value system because they want efficiency

Chinese look for the opportunities and then merit and values

Beliefs about child-raising

Americans let their children live independently

Chinese believe in the principles and their children have to follow them

Attitudes about personal space /privacy

Americans believe in, giving personal space is their right so they do not tend to live in nuclear families, or they even demand personal space out of their homes.

Chinese are not that much rigid about the personal space they let others perform their tasks and duties

Gestures to show you understand what has been told to you

They will make us understand in a peaceful way

Prefer to talk very shortly

Ideas about


Believe on modesty because they know about their legitimate rights and they have the law

Chinese also believe in fairness


Tend more towards fast food

Chinese to eat traditional and healthy food


Welcome people in a happy and peaceful way

Hospitality is important for them, so they greet people with a smile

Facial expressions and hand gestures

They do not shake hands, they only wave

They smile, bow their hands and they close their hands

Work ethic

Punctual and more conscious about their rights

Punctuality and quality services

Religious beliefs

In American culture, people are having various religious beliefs

No official religion

Religious rituals

As many people are having different backgrounds so there is no specific religious ritual

They celebrate rituals yearly

Rules of polite behaviour

They believe in personal space and they prefer to stay peaceful and control themselves

Prefer to stay calm and peaceful

Attitude toward age

No as such treatment towards specific age

There is a lot of respect towards the senior citizens

The role of family

Americans children get separated when their children reach 18 age ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"UAAYhGY7","properties":{"formattedCitation":"(\\uc0\\u8220{}Child-Rearing Practices in Different Cultures,\\uc0\\u8221{} 2016)","plainCitation":"(“Child-Rearing Practices in Different Cultures,” 2016)","noteIndex":0},"citationItems":[{"id":218,"uris":["http://zotero.org/users/local/smYQhi21/items/4TSW4E86"],"uri":["http://zotero.org/users/local/smYQhi21/items/4TSW4E86"],"itemData":{"id":218,"type":"webpage","title":"Child-Rearing Practices in Different Cultures","container-title":"Touro University WorldWide","abstract":"Surveying global parenting reveals that child-rearing practices in different cultures are quite diverse, and the influence culture plays is profound.","URL":"https://www.tuw.edu/health/child-rearing-practices-different-cultures/","language":"en-US","issued":{"date-parts":[["2016",7,19]]},"accessed":{"date-parts":[["2019",11,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Child-Rearing Practices in Different Cultures,” 2016) and Chinese believe that family is important for their development

Becoming Culturally Aware


Healthcare services are provided to everyone regardless of their culture, religion, and their race, but there are some barriers like cultural barriers which hinder the healthcare services. Language is an element of culture and there are many languages all over the globe, however, language becomes a barrier when healthcare providers are unable to communicate with the patient during their treatment. The nurses were not able to understand the Chinese language and they were also unable to communicate a patient's words to the translator.


After watching the video, I realized that there should be a medium of a language so that we would be able to communicate with others. While getting the treatment we should be able to convey our message or medical history with healthcare providers, so that they would prescribe us medication. If someone can communicate his/her message than the person would be treated well, the lack of communication will lead to unexpected consequences like wrong prescription and medication to the patients ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"N0KxtsM4","properties":{"formattedCitation":"(Bramhall, 2014)","plainCitation":"(Bramhall, 2014)","noteIndex":0},"citationItems":[{"id":222,"uris":["http://zotero.org/users/local/smYQhi21/items/NNBI86E4"],"uri":["http://zotero.org/users/local/smYQhi21/items/NNBI86E4"],"itemData":{"id":222,"type":"article-journal","title":"Effective communication skills in nursing practice.","container-title":"Nursing standard (Royal College of Nursing (Great Britain) : 1987)","page":"53-59","volume":"29","issue":"14","source":"Semantic Scholar","abstract":"This article highlights the importance of effective communication skills for nurses. It focuses on core communication skills, their definitions and the positive outcomes that result when applied to practice. Effective communication is central to the provision of compassionate, high-quality nursing care. The article aims to refresh and develop existing knowledge and understanding of effective communication skills. Nurses reading this article will be encouraged to develop a more conscious style of communicating with patients and carers, with the aim of improving health outcomes and patient satisfaction.","DOI":"10.7748/ns.29.14.53.e9355","author":[{"family":"Bramhall","given":"Elaine"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Bramhall, 2014). I believe that the nurses who were in the ward could not communicate the words of a patient with each other and repeat them on the phone to the translator.


The good thing about this experience was the treatment and healthcare facility provided to the patient regardless of her language and her race. While the bad experience was that, all four actors; patient, translator, and the two nurses could not communicate in the beginning, but the patient was able to convey her message to the translator in the last.


I believe that the nurses were trying to help and facilitate the patient in possible ways, and they were trying to communicate with her by approaching a translator. However, the nurse with the patient was trying to make her calm and patient was worried and trying to hold the hand of a nurse so that she would not feel helpless. The patient was getting worried about her communication and she was unable to convey her message and the nurses were trying to repeat the words to the translator ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"hwZb8rtD","properties":{"formattedCitation":"({\\i{}Getting On Season 1 Episode #1 Clip Language Barrier HBO}, n.d.)","plainCitation":"(Getting On Season 1 Episode #1 Clip Language Barrier HBO, n.d.)","noteIndex":0},"citationItems":[{"id":226,"uris":["http://zotero.org/users/local/smYQhi21/items/ARLPF6FM"],"uri":["http://zotero.org/users/local/smYQhi21/items/ARLPF6FM"],"itemData":{"id":226,"type":"motion_picture","title":"Getting On Season 1 Episode #1 Clip Language Barrier HBO","source":"YouTube","dimensions":"2:03","URL":"https://www.youtube.com/watch?v=ThlocfZJzI0","accessed":{"date-parts":[["2019",11,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Getting On Season 1 Episode #1 Clip Language Barrier HBO, n.d.). However, nurses were also unable to follow each other because the nurse communicating with the translator could not pronounce properly. Communication is a skill, and nurses could have communicated with the patient by using actions and they could have connected her to the same language speaker. However, the positive aspect is that they were able to find a translator, who was able to convey her message to healthcare providers.

I believe that this way of communication could have ended in a better way, healthcare management would have called a person who can speak and understand the same language. This was a useful experience because I can understand the barriers which may hinder healthcare and how these barriers can be dealt with in possible ways to avoid risks and emergencies.


I believe that hospitals should hire healthcare providers and nurses belonging to different ethnicities so that they will be able to communicate with the patients and handle the situations before the patients get panic. While there can be a translator who would be communicating with the patients and convey their medical concerns to the nurses.

The positive aspect of this experience is that it made me learn about the importance of teamwork, and how healthcare providers handle emergencies and serve the patients. However, there was a communication gap between nurses that is why they were unable to convey the message.

Action Plan:

The goal should be to communicate and to understand the medical history of the patients so that they will be treated well. The communication gap leads to mishappenings during the treatment of the patients i.e. they tell you something and you misinterpret it. The resources needed to improve the situation would be training to the nursing staff and healthcare providers and there can be an online healthcare system where nurses speaking different languages.

The resource can be found within the health system and management can arrange training sessions conducted by the senior staff because they are more experienced. While there can be an online healthcare session to avoid communication barriers and treat the patients in better ways.

Human Rights:

The new laws have been administered to provide equal rights and to exercise human rights. The act for equal opportunity includes discrimination, harassment and victimization in public life targeting education, employment, and other services. While there is a racial and religious tolerance act, they will help individuals to respond to the unexpected barriers and hindrances. However, there are ways to support individuals but there will be some behaviours which may offend them, so the Charter of Human Rights and Responsibilities have been administered to ensure the human rights ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"8RAxwp7I","properties":{"formattedCitation":"(\\uc0\\u8220{}The Law,\\uc0\\u8221{} n.d.)","plainCitation":"(“The Law,” n.d.)","noteIndex":0},"citationItems":[{"id":212,"uris":["http://zotero.org/users/local/smYQhi21/items/GQF5UXVT"],"uri":["http://zotero.org/users/local/smYQhi21/items/GQF5UXVT"],"itemData":{"id":212,"type":"webpage","title":"The Law","abstract":"Victorian laws administered by the Commission The Victorian Equal Opportunity and Human Rights Commission is an independent statutory body with respon...","URL":"https://www.humanrightscommission.vic.gov.au/home/the-law","language":"en-gb","accessed":{"date-parts":[["2019",11,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“The Law,” n.d.).


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Ajilore, O. (2019, September 17). The Harvest of American Racism. Retrieved November 5, 2019, from Center for American Progress website: https://www.americanprogress.org/issues/economy/news/2019/09/17/474567/harvest-american-racism/

Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard (Royal College of Nursing (Great Britain) : 1987), 29(14), 53–59. https://doi.org/10.7748/ns.29.14.53.e9355

Child-Rearing Practices in Different Cultures. (2016, July 19). Retrieved November 5, 2019, from Touro University WorldWide website: https://www.tuw.edu/health/child-rearing-practices-different-cultures/

Getting On Season 1 Episode #1 Clip Language Barrier HBO. (n.d.). Retrieved from https://www.youtube.com/watch?v=ThlocfZJzI0

The Law. (n.d.). Retrieved November 5, 2019, from https://www.humanrightscommission.vic.gov.au/home/the-law

Subject: Healthcare and Nursing

Pages: 3 Words: 900

Assessment Task 2

Diabetes Mellitus Assignment

[Name of Writer]

[Name of Institution]

1. The alpha cells in the islets of Langerhans produce glucagon; the beta cells produce insulin while the delta cells produce somatostatin. Glucagon functions to increase blood glucose levels; insulin decreases or controls blood glucose levels while somatostatin works in a paracrine function decreasing the secretion of both insulin and glucagon.

2. Gluconeogenesis is the formation of glucose from non-carbohydrate sources of carbon. However, glycogenolysis is the formation of glucose resulting from a breakdown of the polymer glycogen.

3. The steps of educating a diabetic client about maintaining blood sugar are as follows:

The patient must be educated about a blood glucose level testing procedure that can be carried out at home for example, fingersticks or CGM done with an implant.

The patient must be asked to choose the home blood glucose testing method of their choice.

Patient must be trained on monitoring it.

The patient must be asked to decrease glucose intake if the levels rise beyond 2.8mmol/L and increase if the levels fall.

4. Diabetic ketoacidosis is a metabolic complication that results from a scarcity of insulin that has extended over a long period of time. CITATION Ebe16 \l 1033 (Ebenezer A. Nyenwe, 2016) It is defined with the level of acidic ketones in the blood rising to unusual levels and this situation is mostly fatal. There are several metabolic pathways that could contribute to the development of diabetic ketoacidosis, but it is mainly characterized with a lack of insulin and a rise in hormones that counter-regulate insulin. Glucagon plays an important role, but it is not the only factor. The pathogenesis may involve problems in the carbohydrate metabolism (gluconeogenesis), disturbance in the levels of electrolytes or abnormal metabolism of lipids and ketones. Clinically, DKA can be characterized by dehydration visible from loss of turgor in skin or with tachycardia. Blood glucose levels of around 615mg/dl while presence of ketones in urine and in the serum indicate presence of diabetic ketoacidosis.


Hyperosmolar hyperglycemic acidosis mainly occurs in elderly patients of type 2 diabetes CITATION Gui18 \l 1033 (Umpierrez, 2018) mellitus and happens in conditions of stress. It is characterized physiologically by severe dehydration and hyperglycemia aided by a hyperosmolar plasma that may result in an altered consciousness. When hyperglycemia results in inhibition of reabsorption of water in kidneys and increase in urination causing dehydration, it is hyperosmolar hyperglycemic acidosis. A constant state of low insulin and high counter-insulin hormones results in this state.

The diagnostic criteria for hyperosmolar hyperglycemic acidosis involve testing for several biochemical diagnostic markers. The blood glucose levels for a positive result in this regard are above 600mg/dL while the effective osmolarity in plasma has to be above 320mOsm/L. Serum bicarbonates have to be above 18mEq/L and ketones in the serum or the urine have to absent or present in very low amounts. This eliminates the idea that ketoacidosis might be present. If the level of beta hydroxybutyrate in the serum is less than 3mmol/L, it is also a diagnostic marker for hyperosmolar hyperglycemic acidosis. Clinically, the person is in the state of alternative consciousness characterized by stupor or coma. CITATION Fra14 \l 1033 (Umpierrez F. J., 2014)

Basic priorities for managing hyperosmolar hyperglycemic acidosis include resuscitation. Since this is a severe medical emergency, restoring the intravascular volume using an airway in case of a coma is a priority. Managing water and electrolyte levels by fluid management via administering a sodium chloride solution comes next. Correcting hyperglycemia by insulin is the third step. CITATION Sze17 \l 1033 (Sze May Ng, 2017)

6. Other than the clinical presentation, if autoimmune markers (for example, an antibody against glutamic acid decarboxylase) are present, T1DM is confirmed. Low C-peptide levels also confirm TIDM. Antibodies against islet antigens or ZnT8 are also markers. Upregulations in genes like HLA-DQA1 and HLA-DQB1 also confirm T1DM.

7. Diabetes patients need to regularly inspect their feet for any cuts or injuries no matter how minor. Patients should not cut their nails very deep. Patients should wash their feet using lukewarm water. Feet should be washed very gently. Diabetic patients should moisturize their feet regularly. Patients should not moisturize area between their toes to avoid a fungus infection. Patients should report to a doctor immediately if there is a callus on their feet. Patients should wear socks designed for diabetic patients. Patients should keep their feet warm and dry. Patients should have regular examinations of their feet.

8. The HbA1c test checks blood glucose level over two to three months by calculating how many glycated red blood cells are present in the sample. An HbA1c result showing glucose above 48mmol/mol confirms diabetes.


BIBLIOGRAPHY Ebenezer A. Nyenwe, A. E. (2016). The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism, 507-521.

Sze May Ng, J. E. (2017). Hyperglycaemic Hyperosmolar State (HHS) in children: a practical guide to management. Paediatrics and Child Health, 171-175.

Umpierrez, F. J. (2014). Hyperosmolar Hyperglycemic State: A Historic Review of the Clinical Presentation, Diagnosis, and Treatment. Diabetes Care, 3124-3131.

Umpierrez, G. E. (2018). Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. Diabetes Complications, Comorbidities and Related Disorders , 1-21.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Assessment Task Two (2) : Immigration Museum Excursion

Immigration museum excursion

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

Immigration museum excursion



Did you pass? Briefly explain where you failed in your test or why you did not fail the test. 2 marks 2.

I could not pass the test as I lack the knowledge about nationally celebrated days, personal responsibilities as a national, Australian government rules and regulations, election policies, and hiring procedures of government representatives.

Watch Pauline Hanson’s 1996 video


a. What did you think of Pauline Hanson’s speech?

Overall, the speech was powerful covering a range of topics. She addressed inequalities stating that aboriginals are the most disadvantage people in Australia. She also talked about social ethical and legal problems. The one thing I liked the most was she talked about providing support to those facing hurdles in life so they can the chances to rebuild themselves and have a good future. However, the later part of the speech was purely focused on kicking out the immigrant from Australia. She stressed on the need in change of immigration policies and not to let Asians migrate and settle in China (“Pauline Hanson Maiden Speech IN FULL September 10, 1996—YouTube,” n.d.). Her concerns seemed pointless as no country can survive on its own without letting in people from other countries. Additionally, the immigration strengthens a country’s economy (Hinojosa-Ojeda, 2012; Borjas, 1995).

b. How did it make you feel as an Australian or a recent migrant?

When I was planning to move to Australia, I tried to do a little research about the native Australian’s views about the immigrants (“Pauline Hanson Maiden Speech IN FULL September 10, 1996—YouTube,” n.d.). I am not surprised knowing her point of view. Everyone is free to have their own thoughts and perception about this issue. But what I have heard and experienced so far, people around me are not racist. They are more welcoming and approachable than I expected. Watching this video made me a little but upset but what I feel is this in not majority’s voice and most people are different.

c. Do you agree with some of her thoughts? Explain your response briefly.

I do agree with her to some extent but her view that ‘Australians are endangered by Asians’ is not correct. Good and bad people exist in all cultures and religions. This does not mean the whole nation is in danger from a specific ethnic group. Another point which I do not agree on is the about the strength of the society. According to Hanson, a multicultural society is not strong. I my view it is exactly the opposite, a multicultural nation is stronger with the diversity in religions and cultures (Kymlicka & Banting, 2006).

Watch Kevin Rudd’s 2008 Apology to the Stolen Generations video https://museumvictoria.com.au/immigrationmuseum/discoverycentre/identity/people-like-them/the-white-picketfence/kevin-rudds-2008-apology-to-the-stolen-generations/

Did you find it an emotional experience?

The speech was truly emotional and had me in tears (“Australian Prime Minister Kevin Rudd apology speech—YouTube,” n.d).

Did you agree or disagree with saying sorry?

I do agree with the prime minister Kevin. He tried to make immigrants feel that their existence does matter to the country and that they belong here. The nation stands with them in their losses (“Australian Prime Minister Kevin Rudd apology speech—YouTube,” n.d.)

Did it affect you directly?

The words did affect me directly (“Australian Prime Minister Kevin Rudd apology speech—YouTube,” n.d). Being and immigrant, leaving your mother land behind forever, getting settled in a new place is really tough and all you need is a few words of kindness and warmth. His speech really provided me comfort and reduced my stress.

Poh wanted to be like everyone else in her new country and was “Desperately wanting to assimilate as a child migrant, I shed everything that made me feel different in my new country. “Poh Ling Yeow, Cook, TV Presenter, Artist, 201

Why do we need to belong?

We need to belong to a place to be accepted by the natives and aboriginals. The biggest challenge is acceptance of immigrants in a community. Survival is difficult in a new place is extremely difficult if the locals do not mix up and welcome them. In an effort to be accepted, the immigrants like Poh forget their identity and try taking a new start to get settled.

Who do you belong with?

People belong to the place they live. For example. being an immigrant, I belong to Australia.

“Difference is not an easy thing to accommodate. It's not simple to embrace and respect and defend cultures that are different to your own. That's the nature if you like of human relationships. We gotta work and build on it. And it’s by having these sorts of debates, getting people to think about it and talk about it that we're going to move along.” Mick Dodson, Co-Chair Reconciliation Australia, 1996 In Australia who fits in? Who doesn’t? And who gets to decide? Write a reflective paragraph about the above quote

The people who are born and raised in Australia can fit in easily, but the new immigrants face several challenges getting settled here. I agree with Mick that the change and differences are not easy to be accepted whether it is cultural or societal. And they only way to help merging of people from multi-cultural backgrounds is by talking on the matter.

“Let us keep before us the noble ideal of a white Australia, a snow-white Australia if you will. Let us be pure and spotless” Reverend James Back Ronald, member of House of Representatives, 1901 Describe briefly what was the white Australia policy and when was it abolished?

White Australian policy, formally called Immigration Restriction Act, was term used to assemble the laws to stop nonwhite immigrants from migrating to Australia. The policy effectively stopped people from non-Europe background immigrating to Australia. The policy was ended after World War II as the government wanted to attract immigrants to Australia. The prime minister Harold Holt officially ended the policy in 1966

We pride ourselves on our generosity and the diversity of our society. Walking down our city streets we are surrounded by difference. But how do we feel when difference moves in next door? Or sits next to us on the tram or in the classroom? Watch all 4 videos and see if you can see yourself.


Have you seen or experienced this kind of scenario before?

I have seen a similar scenario in a bus when a lady sitting next to was wearing Hijab and an white guy got on the bus, walked towards us and sat exactly opposite to us. After being uncomfortably starring at her, he starts talking to her in indecent manner pointing towards her Hijab. He started passing comments like why do you think you are wearing this thing. Does it make you feel protected? Why do always need to cover your head, it needs some oxygen and so on. They lady did not respond to her and got off on the next stop.

How would you react? How did it make you feel?

If it was me, I might have reacted the same way. Ignoring and not getting into any type of argument. It would have made me feel very uncomfortable and unsafe.


Hinojosa-Ojeda, R. (2012). The economic benefits of comprehensive immigration reform. Cato J., 32, 175.

Borjas, G. J. (1995). The economic benefits from immigration. Journal of economic perspectives, 9(2), 3-22.

Kemnitz, A. (2003). Immigration, unemployment and pensions. Scandinavian Journal of Economics, 105(1), 31-48.

Kymlicka, W., & Banting, K. (2006). Immigration, multiculturalism, and the welfare state. Ethics & International Affairs, 20(3), 281-304.

Pauline Hanson Maiden Speech IN FULL September 10, 1996—YouTube. (n.d.). Retrieved October 17, 2019, from https://www.youtube.com/watch?v=hkV1PkPj7ZA

Australian Prime Minister Kevin Rudd apology speech—YouTube. (n.d.). Retrieved October 17, 2019, from https://www.youtube.com/watch?v=aKWfiFp24rA

Subject: Healthcare and Nursing

Pages: 3 Words: 900

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